title: Reproducibility of telecytology diagnosis of cervical smears in a quality assurance program: the Georgian experience.
abstract: OBJECTIVE
  The study evaluated the reproducibility of telecytology diagnosis of cervical smears on a randomly selected 50 cases under the conditions of Georgia.
  
  
  METHODS
  Fifty cervical smears (benign, 14; atypical squamous cells of undetermined significance [ASCUS], 14; low-grade squamous intraepithelial lesion [LSIL], 10; high-grade squamous intraepithelial lesion [HSIL], 12) were selected. The digital images were captured at a maximum resolution of 2048 × 1536 pixels and transmitted by electronic mail. Diagnosis of glass slides and digital images was done independently in a double-blind manner by three cytologists, versus the diagnosis of digital images followed by diagnosis of glass slides 3 months later. The procedure was repeated after 3 months.
  
  
  RESULTS
  Diagnoses were recorded as benign, ASCUS, LSIL, and HSIL. Diagnostic accuracy and interobserver reproducibility were analyzed using an interclass correlation coefficient, which revealed good interobserver agreement for the first (0.82) and second (0.68) glass slide diagnoses and the first (0.80) and second (0.66) digital image diagnoses. The kappa values for interobserver variation between first and second glass slide diagnoses and first and second digital image diagnoses showed good to excellent agreement.
  
  
  CONCLUSIONS
  Digital images are suitable substitutes for glass slides; telecytology can be used as an alternative method for the cytologic diagnosis of cervical smears, particularly in quality assurance programs.
authors.affiliation: Georgian Telemedicine Union (Association), Tbilisi, Georgia. ekldiashvili@yahoo.com
authors.forename: Ekaterina
authors.initials: E
authors.lastname: Kldiashvili
authors.forename: Thomas
authors.initials: T
authors.lastname: Schrader
mesh_terms: D034742:Electronic Mail; D005260:Female; D005846:Georgia (Republic); D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D019113:Telepathology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000473:pathology; D014626:Vaginal Smears / Q000379:methods* / Q000592:standards; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000473:pathology