The use of virtual microscopy for proficiency testing in gynecologic cytopathology: a feasibility study using ScanScope.
BACKGROUND
ScanScope software can digitize entire cytology slides.


OBJECTIVE
To test the feasibility of using virtual microscopy methods and "virtual Papanicolaou tests" for proficiency testing (PT) in gynecologic cytopathology.


METHODS
Two PT exercises were conducted using virtual microscopy. Five cytopathologists and 1 cytotechnologist interpreted images using 2 different schema as follows: (1) the College of American Pathologists graded diagnostic codes (CAP-GDCs) and (2) the Center for Medicare and Medicaid Services test scoring categories (CMS-TSCs). The number of diagnostic errors using the CAP-GDCs and the CMS-TSCs, the mean length of time spent diagnosing each case, and the impressions by the users regarding the facility of the technology and image quality were studied.


RESULTS
In the first PT exercise, the participants provided incorrect diagnoses in 4 to 8 of the 10 test cases using the CAP-GDCs and in 1 to 4 of the 10 test cases using the CMS-TSCs. In the second PT exercise, the number of errors decreased to 1 to 6 using the CAP-GDCs and to 0 to 6 using the CMS-TSCs. The results did not achieve statistical significance. The mean time of 9.4 minutes spent per case in the second PT exercise was significantly shorter than the 14.4 minutes spent per case in the first PT exercise (P < .001). The ease of use of the software and the image quality were scored by all participants as 3+ or as 4+.


CONCLUSIONS
This preliminary study shows that virtual microscopy and virtual Papanicolaou tests prepared using ScanScope may provide effective tools for PT. Technical issues that require further investigation are discussed.
Marchevsky
Alberto M
AM
Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California 90038, USA. marchevsky@cshs.org
Khurana
Renu
R
Thomas
Premi
P
Scharre
Karen
K
Farias
Paul
P
Bose
Shika
S
D003951:Diagnostic Errors / Q000517:prevention & control; D005240:Feasibility Studies; D005260:Female; D006176:Gynecology / Q000592:standards*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007755:Laboratories, Hospital; D008853:Microscopy / Q000379:methods*; D065006:Papanicolaou Test; D015203:Reproducibility of Results; D012955:Societies, Medical; D014481:United States; D014626:Vaginal Smears / Q000592:standards*