title: The value of expert review in prospective trials of automated assisted screening devices.
abstract: Previous prospective studies of automated assisted gynecologic screening devices have used a panel of experts for truth determination. We sought to determine the value of this practice. The relative sensitivity of the devices compared with manual screening was calculated using an expert panel for truth determination and compared using likelihood ratios to the relative sensitivity assuming all abnormal cases were truly abnormal. These results show that expert panel review has no significant effect on relative sensitivity at the threshold of ASCUS+ but may have an effect at HSIL+. Trials without expert consensus review may be compared to those with expert consensus review at the threshold of ASCUS+ but may not be reliable at the threshold of HSIL+ without additional confirmatory data.
authors: Department of Pathology, Baptist Hospital, Miami, Florida.
authors: Andrew A
authors: AA
authors: Renshaw
authors: Tarik M
authors: TM
authors: Elsheikh
mesh_terms: D001706:Biopsy / Q000295:instrumentation / Q000592:standards; D002986:Clinical Trials as Topic; D032921:Consensus; D003584:Cytological Techniques / Q000295:instrumentation*; D005069:Evaluation Studies as Topic; D005260:Female; D058869:Gynecological Examination / Q000295:instrumentation* / Q000592:standards*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000295:instrumentation*; D016013:Likelihood Functions; D008403:Mass Screening / Q000295:instrumentation* / Q000592:standards*; D065006:Papanicolaou Test / Q000295:instrumentation / Q000592:standards; D011361:Professional Competence / Q000592:standards*
keywords: Pap smear; gynecologic cytology; performance; sensitivity; workload