Interlaboratory Quality Control in Gynecologic Cytopathology Using the Novel CONQUISTADOR Software

Reproducibility of Classification and Correction for Verification Bias as Determinants of Performance of Papanicolaou Smear Cytology in the Screening Setting

“…When default weights are used, the weighted κ test gives values identical to those with another statistical test, ICC, which is used instead of weighted κ in many statistical software programs (e.g., SPSS). 28,29,36 Being more "forgiving," calculating weighted κ for the original classification results in κ = 0.771, which indicates a substantial agreement. This is very close to the values obtained in our recent interlaboratory quality control study in Latin America.…”

“…This is very close to the values obtained in our recent interlaboratory quality control study in Latin America. 29 In viewing the contingency table (Table I), it is evident that the main difference between NIS and the RC findings was the practice of classifying the samples into class 2 category-956 and 580 cases, respectively. In other words, the majority of cases categorized as class 2 in NIS were called normal (class 1) by the RC.…”

“…These figures are fully comparable with the results reported in the LAMS study, in which TBS was used as the original classification. 29 Thus, in any future transformations of the existing different modifications of the Papanicolaou classification to TBS, 12,13 it is essential to carefully consider where to settle the cutoff for the ASCUS category.…”

“…7,8,15,18,[21][22][23][24][25][26] As part of our systematic efforts to improve the quality of conventional Pap smear cytology, 21,22,25,27 we recently developed laboratory software (CONQUISTADOR) to assist this intraobserver and interlaboratory quality assurance, validated in a simulation study 28 and recently shown useful in a screening setting ongoing in Latin America (the LAMS study). 29 In addition to the discussed technical, classification and reproducibility issues, performance of Pap smear cytology in a screening setting also critically depends on the prevalence of the abnormalities (squamous intraepithelial lesion [SIL] and cervical cancer) in the target population. 2,3,9 Of importance, performance of various screening tools (cytology included) is also dramatically different among young women and those > 30-35 years, as recently demonstrated in the LAMS study.…”

Recommendations on Quality Control and Quality Assurance in Cervical Cytology

“…Certification is an inherent part of the training process and provides the recognition that the training and continued education were satisfactory [42]. Continuous overseeing of the accuracy and reproducibility of cytological examination (error of the primary screening, from incomplete examination or misinterpretation and error of supervision) is guaranteed by QC programmes which take into account all the possible causes of error [46,48]. It should be noted that the smaller the volume of activity (number of Pap tests per year), the more detailed and defined must be the QC programmes that are put in place [47,49,50].…”