title: Observer variation in cytologic grading for cervical dysplasia of Papanicolaou smears with the PAPNET testing system.
abstract: BACKGROUND
  To assess the interobserver and intraobserver variation of Papanicolaou (Pap) smear screening with the computer-assisted (neural network based) PAPNET Testing System in diagnosing cervical smear abnormalities, results of agreement were compared with the interobserver and intraobserver variation of conventional smear analysis.
  
  
  METHODS
  Cervical smears obtained from women in 1996 were reevaluated both by conventional light microscopy and with use of the PAPNET Testing System by the same four investigators, and results were compared with the original screening diagnoses obtained by both methods.
  
  
  RESULTS
  The interobserver results for epithelial abnormalities (the degree of agreement between the cytologists), characterized by weighted kappa statistics, were 0.71 (95% CI: 0. 68-0.73) for PAPNET screening and 0.69 (95% CI: 0.66-0.72) for conventional screening. No significant differences were found among the individual results obtained by the four cytotechnologists (intraobserver variation) with conventional screening versus PAPNET reviewing.
  
  
  CONCLUSIONS
  Pap smear grading with the PAPNET Testing System has interobserver and intraobserver variation similar to that of conventional screening of Pap smears in routine use. Cancer (Cancer Cytopathol)
authors.affiliation: Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: H
authors.initials: H
authors.lastname: Doornewaard
authors.forename: Y T
authors.initials: YT
authors.lastname: van der Schouw
authors.forename: Y
authors.initials: Y
authors.lastname: van der Graaf
authors.forename: A B
authors.initials: AB
authors.lastname: Bos
authors.forename: J G
authors.initials: JG
authors.lastname: van den Tweel
mesh_terms: D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008403:Mass Screening / Q000379:methods; D016571:Neural Networks, Computer; D015588:Observer Variation; D065006:Papanicolaou Test; D002578:Uterine Cervical Dysplasia / Q000473:pathology*; D002583:Uterine Cervical Neoplasms / Q000473:pathology; D014626:Vaginal Smears / Q000295:instrumentation* / Q000379:methods / Q000706:statistics & numerical data