Accuracy and reproducibility of telecytology diagnosis of cervical smears: A tool for quality assurance programs

Eung Seok Lee, In Sun Kim, Jong Sang Choi, Bom Woo Yeom, Han Kyeom Kim, Jong Ho Han, Mi Sook Lee, Anthony S.Y. Leong

Research output: Contribution to journalArticlepeer-review

50 Citations (Scopus)

Abstract

We randomly selected 50 cervical smears (benign, 14; atypical squamous cells of undetermined significance [ASCUS], 5; low-grade squamous intraepithelial lesion [LSIL], 10; high-grade squamous intraepithelial lesion (HSIL), 12; squamous cell carcinoma, 6; adenocarcinoma, 3) and captured 1,181 digital images (518 MB) at a maximum resolution of 1,600 × 1,200 pixels and transmitted them by e-mail. Diagnosis of glass slides and digital images was done independently in a double-blind manner by 3 pathologists and 3 cytotechnologists, commencing with the diagnosis of digital images followed by diagnosis of glass slides 3 months later. The procedure was repeated after 3 months. Diagnoses were recorded as benign, ASCUS or atypical glandular cells of undetermined significance, LSIL, HSIL, squamous cell carcinoma or adenocarcinoma, and "inadequate for diagnosis." Diagnostic accuracy and interobserver reproducibility were analyzed using an intraclass correlation coefficient (ICC), which revealed good interobserver agreement for the first (0.72) and second (0.64) glass slide diagnoses and the first (0.72) and second (0.60) digital image diagnoses. The kappa values for intraobserver variation between first and second glass slide diagnoses and first and second digital image diagnoses showed moderate to excellent agreement. 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.

Original languageEnglish
Pages (from-to)356-360
Number of pages5
JournalAmerican Journal of Clinical Pathology
Volume119
Issue number3
DOIs
Publication statusPublished - 2003 Mar 1

Keywords

  • ASCUS
  • Adenocarcinoma
  • Atypical squamous cells of undetermined significance
  • Cervical smears
  • Digital images
  • HSIL
  • High-grade squamous intraepithelial lesion
  • LSIL
  • Low-grade squamous intraepithelial lesion
  • Squamous carcinoma
  • Telecytology

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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