title: Assessment of specimen adequacy reproducibility: an Italian experience.
abstract: Interobserver disagreement on smear adequacy may influence the evaluation of the performance of samplers as well as Pap test sensitivity and follow-up. In 1998, the Italian Group for Cervical Cancer Screening (GISCi) promoted a study on the reproducibility of adequacy criteria using a modified version of the Bethesda system. A set of 200 smears was circulated among six Italian laboratories situated in different parts of the country. For each smear, participants were requested to provide a summary judgment on its adequacy and on the cause(s) of inadequacy, if any. Agreement was measured using kappa-type statistics. The agreement among laboratories was generally good. In comparisons, among five laboratories, kappa values ranged from 0.47 to 0.66. At the consensus meeting on 42 slides, on which at least 2 laboratories dissented from the majority, agreement was reached unanimously for 31 reviewed slides and among 5-6 centers for 11. In this article, some guidance is given in order to attribute to one of the two categories satisfactory/unsatisfactory those smears that have been traditionally considered as candidates for the category of "satisfactory but limited by em leader " (SBLB). New Italian guidelines on adequacy proposed the GISCi are presented and the recommendation is made to eliminate the SBLB category.
authors.affiliation: Prevenzione Serena, CPO Piemonte, Torino, Italy.
authors.forename: Gioia
authors.initials: G
authors.lastname: Montanari
authors.forename: Massimo
authors.initials: M
authors.lastname: Confortini
authors.forename: Alberto
authors.initials: A
authors.lastname: Bellomi
authors.forename: Valeria
authors.initials: V
authors.lastname: Cocchi
authors.forename: Paolo
authors.initials: P
authors.lastname: Dalla Palma
authors.forename: Enrico
authors.initials: E
authors.lastname: D'Ambrosio
authors.forename: Maria Rosaria
authors.initials: MR
authors.lastname: Giovagnoli
authors.forename: Roberto
authors.initials: R
authors.lastname: Navone
authors.forename: Guglielmo
authors.initials: G
authors.lastname: Ronco
mesh_terms: D005260:Female; D006801:Humans; D007558:Italy; D015588:Observer Variation; D015203:Reproducibility of Results; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000453:epidemiology; D014626:Vaginal Smears / Q000592:standards*