New Statistical Software for Intralaboratory and Interlaboratory Quality Control in Clinical Cytology

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.…”

“…are less severe than those misclassifying the samples by several degrees (e.g., class 4 cells being called class 1 or 2), it has become conventional to use weighted κ in calculating the reproducibility of cytology. 27,28,[36][37][38] In calculating weighted κ, different weights can be given to different rating levels, to take into account the severity of misclassification. 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).…”

“…Most important, these include technical innovations in the late 1990s leading to the development of liquid-based cytology techniques, 9 cytology automation [1][2][3]12,13 and rigorous quality control measures to improve the reproducibility. 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.…”

Recommendations on Quality Control and Quality Assurance in Cervical Cytology

“…It is also mandatory to systematically monitor the quality of all these procedures and set standards for all of the health professionals involved. Internal quality procedures should be a priority, and an external audit on the QC and QA measures of the laboratory is also required [59,60]. Training personnel is fundamental to maintain high-quality skills and experienced and preferentially certified professionals in continuous education programmes.…”

A Quality Control Study on Cytotechnologist-Cytopathologist Concordance and Its Relationship to the Number of Dots on the Slide

“…Its ability to detect abnormal cells can be compromised at several points, however, [1][2][3] and its efficacy needs continuous monitoring of all the steps that lead to the Subjective impressions about a CT's performance sometimes can be wrong and misleading.…”