Interobserver variability of cervical smears with squamous-cell abnormalities: a Philadelphia study Journal Article


Authors: Young, N A; Naryshkin, S; Atkinson, B. F.; Ehya, H; Gupta, P K; Kline, T S; Luff, R D
Article Title: Interobserver variability of cervical smears with squamous-cell abnormalities: a Philadelphia study
Abstract: The reproducibility of reporting squamous lesions by the Bethesda System (TBS) was evaluated by distributing 20 slides to be classified among 5 panelists considered experts in the field of cytopathology. Four cases were chosen for their classic morphology and the remainder were foreseen to produce possible discrepancies within one diagnostic category. For 7/20 (35%) cases there was unanimous agreement. Participants disagreed within one category of magnitude for seven (35%) cases. In six (30%) cases there was a range of more than one category disagreement. However, additional written comments modifying TBS diagnoses often diminished the clinical significance of these discrepancies. We conclude that despite the important role of TBS in standardization of Pap smear reports, a great degree of subjectivity exists in classifying squamous abnormalities without "classic" morphology. The lack of reproducibility should be taken into account in cytology proficiency testing.
Keywords: Humans; Female; Reproducibility of Results; *Observer Variation; Epithelium/pathology; Uterine Cervical Neoplasms/*pathology; Cervix Uteri/*pathology; Carcinoma, Squamous Cell/pathology; Uterine Cervical Dysplasia/pathology; Vaginal Smears/*statistics & numerical data
Journal Title: Diagnostic cytopathology
Volume: 11
Issue: 4
ISSN: 8755-1039
Publisher: Wiley-Liss  
Publication Place: UNITED STATES
Date Published: 1994-01-01
Start Page: 352
End Page: 7
Language: eng
Notes: MEDLINE