title: An international telecytologic quiz on urinary cytology reveals educational deficits and absence of a commonly used classification system.
abstract: Urinary cytology is limited by high interobserver variability in the evaluation of cells with little atypia. We set up an online quiz on urinary cytology and tested the performance of 246 international participants. The quiz consisted of still images of 42 urinary specimens with equivocal morphologic features and 10 control cases with an unequivocal cytologic diagnosis. The nature of the cells on the 292 quiz images had been verified by multitarget fluorescence in situ hybridization in addition to the information obtained by cystoscopy, clinical follow up, and/or histologic examination. The original quiz cases and the percentage of answers given by the participants can be viewed at: http://kathrin.unibas.ch/urinzyto/. High-grade cancers were diagnosed correctly in 76.0% and low-grade cancers in only 33.9%. Remarkably, 54.5% of all participants misclassified decoy cells as malignant. This study shows that large-scale international online quizzes may be used to find educational deficits in cytopathology.
authors.affiliation: Regional/University Department for Pathology, Basel and Liestal, Switzerland.
authors.forename: Katharina
authors.initials: K
authors.lastname: Glatz
authors.forename: Niels
authors.initials: N
authors.lastname: Willi
authors.forename: Dieter
authors.initials: D
authors.lastname: Glatz
authors.forename: Audrey
authors.initials: A
authors.lastname: Barascud
authors.forename: Bruno
authors.initials: B
authors.lastname: Grilli
authors.forename: Michelle
authors.initials: M
authors.lastname: Herzog
authors.forename: Peter
authors.initials: P
authors.lastname: Dalquen
authors.forename: Georg
authors.initials: G
authors.lastname: Feichter
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Gasser
authors.forename: Tullio
authors.initials: T
authors.lastname: Sulser
authors.forename: Lukas
authors.initials: L
authors.lastname: Bubendorf
mesh_terms: D002965:Classification / Q000379:methods*; D002983:Clinical Competence; D003581:Cytodiagnosis; D003951:Diagnostic Errors; D004502:Education, Medical, Continuing; D004521:Educational Measurement; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D015588:Observer Variation; D015203:Reproducibility of Results; D019113:Telepathology; D016482:Urinalysis; D014556:Urine / Q000166:cytology*; D014570:Urologic Diseases / Q000175:diagnosis* / Q000652:urine