title: A comparison of ThinPrep Imager-assisted with manual screening, and its place in the New Zealand cervical cancer screening program.
abstract: Overseas studies have shown equivalent sensitivity and specificity between computer-assisted screening and manual screening, with increased screener productivity. This study was undertaken to test these in a New Zealand laboratory setting.
  
  
  
  A total of 9232 slides were read manually alone, and following ThinPrep Imager-assisted screening, and the results compared. Two senior screeners and a cytopathologist reviewed the slides with discordant results.
  
  
  
  The detection rate for abnormalities was 7.30% for Imager-assisted screening and 7.83% for manual screening. The concordance in diagnosis of abnormalities ranged from 72.7% to 100% with the lowest concordance for high-grade abnormalities diagnosed by Imager-assisted screening. The rate of unsatisfactory smears with Imager-assisted screening is half that of manual screening. There was a screener productivity increase of 140%. In all but one case, abnormal cells were identified by the Imager but screeners varied in their interpretations.
  
  
  
  Overall, Imager-assisted screening was as sensitive as manual screening, and more sensitive for high-grade lesions, with a halving of the rate of unsatisfactory smears. In the setting of the New Zealand cervical screening program, the initial screen by the Imager removes the need for a second, rapid rescreen required by the program for manual screening.
authors.affiliation: Department of Histology, Diagnostic Medlab Auckland, Ellerslie, Auckland, New Zealand. myeong@dml.co.nz
authors.forename: Mee Ling
authors.initials: ML
authors.lastname: Yeong
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Pringle
authors.forename: Joanna
authors.initials: J
authors.lastname: Stewart
authors.forename: Erin
authors.initials: E
authors.lastname: Retter
mesh_terms: D002584:Cervix Uteri / Q000473:pathology; D002983:Clinical Competence; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D003951:Diagnostic Errors / Q000517:prevention & control; D003952:Diagnostic Imaging / Q000379:methods*; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006801:Humans; D009520:New Zealand / Q000453:epidemiology; D010338:Pathology, Clinical / Q000379:methods; D012680:Sensitivity and Specificity; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D014626:Vaginal Smears / Q000379:methods*