Document Detail

Interlaboratory quality control in gynecologic cytopathology using the novel CONQUISTADOR software. Interobserver reproducibility in the Latin American screening study.
MedLine Citation:
PMID:  18077979     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The recently developed software (CONQUISTADOR), capable of computing all intralaboratory and interlaboratory quality control (QC) indicators, was used to evaluate the diagnostic agreement among 4 cytology laboratories participating in the LAMS Study. STUDY DESIGN: The study was an interlaboratory exchange of specially designed 5 slide sets, each comprising 20 (conventional cytology) slides. At the first step, 80 slides (with "clear-cut" cases) were divided into four sets (A, B, C, D) of 20 specimens, each including inadequate and negative cases as well as in different proportions of all diagnostic TBS 2001 categories. In the second round, a fifth set (E) of 20 slides ("difficult cases") was designed, with all diagnostic categories, ASC and AGC included. Common measures of reproducibility (kappa and weighted kappa), accuracy (SE, SP, PPV, NPV) and 3 indices of diagnostic variability were calculated for sets A-D and set E, separately. RESULTS: For the 5 slide sets together, the weighted kappa was 0.8 (95% CI 0.76-0.85), which is the lower limit of the "almost perfect" ranking of kappa statistics, indicating an excellent interlaboratory agreement. The interlaboratory reproducibility was lower only for the difficult set (E). Similarly, the sensitivity for set E (70.0%) was lower than that (92.1%) for sets A-D. The diagnostic variability indices were not substantially different between the difficult (set E) and clearcut (sets A-D) cases. CONCLUSION: High interlaboratory reproducibility was obtained for sets A-D ("clear-cut" cases), while more interlaboratory variation was evident in the difficult samples. The new CONQUISTADOR software is a valuable tool in calculating the indicators needed in this intralaboratory and interlaboratory.
Mauro Alderisio; Margherita Branca; Mojca Erzen; Adhemar Longatto-Filho; Sophie Derchain; Silvio Tatti; Susana Vighi; Cecilia Roteli-Martins; Luciano Leoncini; Marina Y S Maeda; Douglas Montis; Renata Gontijo; Luis Otavio Sarian; Kari Syrjänen
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Acta cytologica     Volume:  51     ISSN:  0001-5547     ISO Abbreviation:  Acta Cytol.     Publication Date:    2007 Nov-Dec
Date Detail:
Created Date:  2007-12-14     Completed Date:  2008-01-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370307     Medline TA:  Acta Cytol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  872-81     Citation Subset:  IM    
Unit of Cytopathology, National Center of Epidemiology, Surveillance and Promotion of Health, National Institute of Health (ISS), Rome, Italy.
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MeSH Terms
Laboratories / standards*
Latin America
Mass Screening / standards*
Quality Control
Reproducibility of Results
Total Quality Management / methods*
Uterine Cervical Neoplasms / diagnosis*
Vaginal Smears / standards*

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