Inter-Observer Variation in Reporting of Pap Smears
Introduction: The Papanicolaou smear is one of the most important tests in preventive health care which helps to identify women at risk of developing cervical cancer. The use of the test is increasing because of more awareness. But the validity of the test has always been questioned because rep...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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JCDR Research and Publications Pvt. Ltd.
2016-07-01
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| Series: | National Journal of Laboratory Medicine |
| Subjects: | |
| Online Access: | http://www.njlm.net/articles/PDF/2135/20002_F(P)_PF1(VsuGH)_PFA(GH)_PF2(VsuGH).pdf |
| _version_ | 1818063470601437184 |
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| author | Ramya B Siddegowda Divya Rani MN Natarajan M Dayananda S Biligi |
| author_facet | Ramya B Siddegowda Divya Rani MN Natarajan M Dayananda S Biligi |
| author_sort | Ramya B Siddegowda |
| collection | DOAJ |
| description | Introduction: The Papanicolaou smear is one of the most
important tests in preventive health care which helps to
identify women at risk of developing cervical cancer. The
use of the test is increasing because of more awareness.
But the validity of the test has always been questioned
because reporting of Pap smears is known to have interobserver and intra-observer variation, which can affect the
prognosis of the patients or sometimes create legal issues
too.
Aim: To assess the frequency of discordant diagnosis
between the pathologists in reporting of conventional Pap
smears using the Bethesda System of reporting.
Materials and Methods: A total of 200 cases of Pap
smears with each case having 2 slides (ectocervix and
endocervix) which were received, are labelled and stained
using Papanicolaou stain. The slides are reported by a
pathologist using the Bethesda System of reporting Pap
smears. The reported slides are then reviewed by the
second pathologist with the same level of experience and
again reported following the same protocols. For those
cases which had disagreement, the reports were confirmed
by biopsy. If the biopsy could not be obtained, opinion
was taken from the senior pathologist whose report was
considered as a tie breaker.
Statistical Analysis: Statistical analysis was done using
Kappa statistics for all cases which had epithelial cell
abnormality.
Results: Among 200 cases, 22 cases had epithelial cell
abnormality. The degree of agreement between the results
obtained in the first and second assessment between the
observers was analysed, with the overall Kappa of 0.61,
indicating a moderate agreement.
Conclusion: Inter-observer variation is a common screening
error in reporting of Pap smears. It is necessary to implicate
corrective actions to reduce such error which ultimately
helps in detecting the cervical lesions in its earliest, which
in turn affects the prognosis of the patients. |
| first_indexed | 2024-12-10T14:20:37Z |
| format | Article |
| id | doaj.art-e0473efd668949a39d331cc618cfe066 |
| institution | Directory Open Access Journal |
| issn | 2277-8551 2455-6882 |
| language | English |
| last_indexed | 2024-12-10T14:20:37Z |
| publishDate | 2016-07-01 |
| publisher | JCDR Research and Publications Pvt. Ltd. |
| record_format | Article |
| series | National Journal of Laboratory Medicine |
| spelling | doaj.art-e0473efd668949a39d331cc618cfe0662022-12-22T01:45:13ZengJCDR Research and Publications Pvt. Ltd.National Journal of Laboratory Medicine2277-85512455-68822016-07-0153PO22PO2510.7860/NJLM/2016/20002:2135Inter-Observer Variation in Reporting of Pap SmearsRamya B Siddegowda0Divya Rani MN1Natarajan M2Dayananda S Biligi3Assistant Professor, Department of Pathology, Bangalore Medical College and Research Institute, Bangalore, India.Tutor, Department of Pathology, Bangalore Medical College and Research Institute, Bangalore, India.Professor, Department of Pathology, Bangalore Medical College and Research Institute, Bangalore, India.Professor and HOD, Department of Pathology, Bangalore Medical College and Research Institute, Bangalore, India.Introduction: The Papanicolaou smear is one of the most important tests in preventive health care which helps to identify women at risk of developing cervical cancer. The use of the test is increasing because of more awareness. But the validity of the test has always been questioned because reporting of Pap smears is known to have interobserver and intra-observer variation, which can affect the prognosis of the patients or sometimes create legal issues too. Aim: To assess the frequency of discordant diagnosis between the pathologists in reporting of conventional Pap smears using the Bethesda System of reporting. Materials and Methods: A total of 200 cases of Pap smears with each case having 2 slides (ectocervix and endocervix) which were received, are labelled and stained using Papanicolaou stain. The slides are reported by a pathologist using the Bethesda System of reporting Pap smears. The reported slides are then reviewed by the second pathologist with the same level of experience and again reported following the same protocols. For those cases which had disagreement, the reports were confirmed by biopsy. If the biopsy could not be obtained, opinion was taken from the senior pathologist whose report was considered as a tie breaker. Statistical Analysis: Statistical analysis was done using Kappa statistics for all cases which had epithelial cell abnormality. Results: Among 200 cases, 22 cases had epithelial cell abnormality. The degree of agreement between the results obtained in the first and second assessment between the observers was analysed, with the overall Kappa of 0.61, indicating a moderate agreement. Conclusion: Inter-observer variation is a common screening error in reporting of Pap smears. It is necessary to implicate corrective actions to reduce such error which ultimately helps in detecting the cervical lesions in its earliest, which in turn affects the prognosis of the patients.http://www.njlm.net/articles/PDF/2135/20002_F(P)_PF1(VsuGH)_PFA(GH)_PF2(VsuGH).pdfcervical cancercytologydisagreement |
| spellingShingle | Ramya B Siddegowda Divya Rani MN Natarajan M Dayananda S Biligi Inter-Observer Variation in Reporting of Pap Smears National Journal of Laboratory Medicine cervical cancer cytology disagreement |
| title | Inter-Observer Variation in Reporting of Pap Smears |
| title_full | Inter-Observer Variation in Reporting of Pap Smears |
| title_fullStr | Inter-Observer Variation in Reporting of Pap Smears |
| title_full_unstemmed | Inter-Observer Variation in Reporting of Pap Smears |
| title_short | Inter-Observer Variation in Reporting of Pap Smears |
| title_sort | inter observer variation in reporting of pap smears |
| topic | cervical cancer cytology disagreement |
| url | http://www.njlm.net/articles/PDF/2135/20002_F(P)_PF1(VsuGH)_PFA(GH)_PF2(VsuGH).pdf |
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