Partial rescreening was carried out on 9633 cervical smears reported as negative by standard screening. Each slide was 'step-screened' at normal speed for 30 s. Thirteen false negative smears were detected by this method. No false negatives were revealed by conventionally rescreening 10% of the same study group. The sensitivity of the method was assessed by 'step-screening' 100 known positive smears. Of this group 92 were detected. The results indicate that partial rescreening is a sensitive method of quality assurance and should replace conventional 10% proportional rescreening, which is ineffective.

Aims-To determine the sensitivity of the partial rescreening method of rapid review for internal quality control of cervical cytology; to determine which staff members are most suited to undertake it; and to investigate the cell patterns of false negative smears previously detected by the method. Methods-As a prospective study 9517 cervical smears were partially screened by four cytotechnologists using the 'step' method prior to conventional screening and the results compared with the final report. As a retrospective study 62 false negative smears that had been identified by the method over four years were reviewed. Results-A detection rate for dyskaryosis of 86% (range 82-91%) was achieved.Sixteen abnormal smears were missed on conventional screening that had been detected by prescreening. Review of the 62 false negatives revealed three patterns: (1) scanty abnormal cells; (2) abundant dyskaryotic cells presenting as "microbiopsies"; and (3) abundant, readily recognisable abnormal cells. Conclusions-Partial rescreening enables the detection of errors due to both fatigue and misinterpretation. In this laboratory the method has, together with targeted full rescreening, reduced the false negative report rate from 5.0% to 0.4%. For laboratories using a rapid review method to reduce false negative reports, a prescreening trial is recommended in order (1) to select the most effective review method and the staff most suited to undertake it; and (2) to determine the laboratory's sensitivity with the method, as this is required for accurate estimation of the false negative rate. (3 Clin Pathol 1996;49:587-591) Keywords: partial rescreening, rapid review, cervical screening, internal quality control.intraepithelial neoplasia is believed to be less than that for invasive carcinoma, but in some laboratories it may be as high as 20%.3-5 In the United States there has been much media attention devoted to screening errors6 7 and in Britain occasional reports appear in the press. Traditional methods of internal quality control, such as targeted rescreening of previously abnormal and symptomatic cases and 10% random rescreening of negative smears, can only make a limited contribution to reducing the number of false negative reports. This is because only a small proportion of negative smears are rescreened. Recently, partial rescreening8 9 and rapid screening" 01 have been proposed as an improved alternative to 10% random rescreening as a method of internal quality control. The principle of partial rescreening, as proposed by one of us, is that all negative and inadequate smears are subjected to a quick review after conventional screening but prior to issue of the report. Partial rescreening and rapid screening are now known collectively by the umbrella term rapid review and are recommended to NHS laboratories by the Scottish Office Working Party on Internal Quality Control for Cervical Cytology Laboratories12 and a working party set up by the Royal College of Pathologists, the British Society for Clinical Cytology an...

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Helicobacter pylori has been implicated in the pathogenesis of chronic gastritis, gastric and duodenal ulcer, and possibly gastric carcinoma. The organism may be detected by invasive or non-invasive methods with variable sensitivity. Paired gastric biopsy and gastric brush specimens were collected from 83 patients presenting with non-ulcer dyspepsia. One biopsy was tested for urease using the CLOtest, the other was processed to paraffin and consecutive sections were stained with haematoxylin and eosin, modified Giemsa and anti-H. pylori antisera. The brush specimens were stained with a rapid Romanowsky stain (Hema-Gurr) and anti-H. pylori. The CLOtest was positive in 31 cases, the Giemsa biopsy in 25, the anti-H. pylori biopsy in 27, the Hema-Gurr smear in 27 and the anti-H. pylori smear in 19. The sensitivities of the methods after omitting one inadequate biopsy were 96%, 93%, 100%, 96% and 78%, respectively. The specificities were 93% for the CLOtest and 100% for the other methods. While immunocytochemical staining of gastric biopsies may be the most sensitive method for H. pylori identification, the cost and turn around time of the technique may preclude its routine use. Gastric brush cytology is a highly sensitive and specific method for H. pylori detection that is quick and simple to perform. Its application is recommended for the routine diagnosis of H. pylori infection.

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