title: The use of virtual microscopy for proficiency testing in gynecologic cytopathology: a feasibility study using ScanScope.
abstract: 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.
authors.affiliation: Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California 90038, USA. marchevsky@cshs.org
authors.forename: Alberto M
authors.initials: AM
authors.lastname: Marchevsky
authors.forename: Renu
authors.initials: R
authors.lastname: Khurana
authors.forename: Premi
authors.initials: P
authors.lastname: Thomas
authors.forename: Karen
authors.initials: K
authors.lastname: Scharre
authors.forename: Paul
authors.initials: P
authors.lastname: Farias
authors.forename: Shika
authors.initials: S
authors.lastname: Bose
mesh_terms: 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*