Robustness of validation criteria in the College of American Pathologists Interlaboratory Comparison Program in Cervicovaginal Cytology.
BACKGROUND
Field validation of slides used in gynecologic cytology proficiency testing has surfaced as an important issue. Although the precision of diagnoses in peer-reviewed educational programs has been examined, the robustness of the validation criteria for specific types of interpretations used in proficiency testing has not been previously studied.


OBJECTIVE
To evaluate the robustness of validation criteria for slides entering an educational slide program.


METHODS
We reviewed the results of the College of American Pathologists Interlaboratory Comparison Program in Cervicovaginal Cytology and compared the robustness of validation criteria for different reference diagnoses, using a total of 16,948 circulating slides.


RESULTS
Validation criteria could be divided into 2 significantly different groups. The criteria for herpes, Trichomonas, squamous cell carcinoma, and adenocarcinoma were significantly more robust than the diagnoses of unsatisfactory; negative for intraepithelial lesion and malignancy, not otherwise specified; low-grade squamous intraepithelial lesion; and high-grade squamous intraepithelial lesion (P < .001).


CONCLUSIONS
The validation criteria used in the College of American Pathologists Interlaboratory Comparison Program in Cervicovaginal Cytology show 2 different levels of robustness or redundancy. These results have implications for the design of fair proficiency tests. Proficiency testing can be designed with the necessary number of reviews needed for slide validation.
Renshaw
Andrew A
AA
Department of Pathology, Baptist Hospital of Miami, Miami, Fla, USA.
Walsh
Molly K
MK
Blond
Barbara
B
Moriarty
Ann T
AT
Mody
Dina R
DR
Colgan
Terence J
TJ
D002983:Clinical Competence; D005260:Female; D006801:Humans; D009656:North America; D010338:Pathology, Clinical / Q000592:standards*; D011785:Quality Assurance, Health Care; D015203:Reproducibility of Results; D012955:Societies, Medical; D014623:Vaginal Diseases / Q000175:diagnosis*; D014626:Vaginal Smears / Q000592:standards*