Correlation of cytotechnologists' parameters with their performance in rapid prescreening of papanicolaou smears

Djemli, Amina; Khetani, Karim; Case, Bruce W.; Auger, Manon

doi:10.1002/cncr.22166

Cited by 26 publications

(36 citation statements)

References 20 publications

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“…Another disadvantage is that there is no guarantee that the cytologist performs in the same way as a prescreener and routine screener. 23 Another limitation of the methods of rapid screening (100% rapid review and rapid prescreening) that also apply to other review methods is that the performance of these methods is optimal when carried out by cytologists who did not participate in routine screening because any errors of interpretation would probably be repeated. 49 Therefore, laboratories with only 1 cytologist will find difficulty in implementing these methods.…”

Section: Original Article 372mentioning

confidence: 99%

“…As shown in various studies, it is possible to use abnormal cases identified both by rapid prescreening and by routine screening to monitor the performance of professionals in the daily routine of cytology laboratories. 6,9,20,[22][23][24][25] Nonetheless, it is only in Canada and the United Kingdom that this method is being routinely used. 4,25,26 Finally, the high rates of false-negatives constitute one of the principal problems faced by cytology laboratories.…”

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confidence: 99%

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Improvement in the routine screening of cervical smears

Tavares

Sousa

Manrique

et al. 2011

Cancer Cytopathology

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Section: Original Article 372mentioning

confidence: 99%

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confidence: 99%

Improvement in the routine screening of cervical smears

Tavares

Sousa

Manrique

et al. 2011

Cancer Cytopathology

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“…[5][6][7] Using these surrogates, the maximum workload for cytotechnologists can be estimated so they have the best chance of achieving near-100% sensitivity. That workload is 30 slides/d for manual screening of conventional [8][9] and SurePath (BD Biosciences, Franklin Lakes, New Jersey) cases, 10 and an ECA-adjusted workload of 7 cases/d (or 70 cases/d for a laboratory with an ECA rate of 10% where 1 slide is counted as 1 slide) for screening with the ThinPrep Imaging System (Cytyc Corporation, Boxborough, Massachusetts). 5,11 Unfortunately, those workloads are less than the workloads currently being employed in some, if not many, cytology laboratories.…”

Section: Gynecologic Cytology: How Fast?mentioning

confidence: 99%

Quality Improvement in Cytology: Where Do We Go From Here?

Renshaw¹

2011

Archives of Pathology &Amp; Laboratory Medicine

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N Context.-Cytology is a success because of the many quality controls used to ensure the accuracy of its results. Nevertheless, additional information is becoming available to the cytologist, often from untraditional sources, and the best way to use that information to improve the quality of cytology is not yet known.Objective.-To review ways to use new information to improve the quality of cytology.Data Sources.-Review of relevant literature.Results.-Information contained in many sources can be used in new ways to improve the quality of cytology. These include the timing of cytologic and histologic correlation, electronic medical records, workload information, prior aspirations, and molecular tests.Conclusions.-To maintain their high standard of excellence, cytologists should seek to define the most appropriate way to incorporate this new information into their interpretation of individual cases. (Arch Pathol Lab Med. 2011;135:1387-1390 doi: 10.5858/arpa.2010-0606-RA) C ytology is an undeniable success in screening patients and obtaining accurate diagnoses with the least intervention. A significant part of this success is due to the high level of quality found in how the test is performed. Cytology is conducted successfully in every type of practice setting, from the solo pathologist in the community hospital doing it all to the fully specialized practitioner in a tertiary care setting. Even though cytology is composed of complex tests that can be extremely challenging to interpret, success is seen with all types of personnel, including cytotechnologists, private practice pathologists, and academic experts. A cornerstone of this success is the highly effective qualityassessment programs that are used in all these different settings and by all these different personnel.Given this success, one may ask, how can cytology improve on its current level of quality, or where should we go from here? An area in which cytology can improve is in how it uses and integrates prior information into the diagnostic process. Today, there is more information, more types of information, and more different sources of information available to the cytologist than ever before. This information can be specific to the patient (eg, a history of breast cancer that can only be found in the electronic medical record), may be results from large clinical trials, or may be results from new types of testing technologies. Indeed, a recent addition to the College of American Pathologists checklist is the requirement to ensure that the results of all other studies (not just anatomic tests) are correlated with the final diagnosis. 1This review focuses on selected areas of cytology in which there is new information available to the cytologists that may be important in either ensuring or improving the quality of cytology. This review is not meant to be all inclusive. Topics reviewed here include cytologic and histologic correlation, the electronic medical record, workload reporting and monitoring in gynecologic cytology, the importance of prior asp...

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“…This variation in performance for RPS has been documented in some studies. 14,18,19 Interestingly, the RPS screening sensitivity of cytotechnologists is not static over time; it seems that like most tasks humans perform, RPS sensitivity improves with practice. 20 When implementation of RPS is considered in a laboratory, the options available include to either involve all the cytotechnologists or to select a subgroup of cytotechnologists who perform best with RPS.…”

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confidence: 99%

“…20 When implementation of RPS is considered in a laboratory, the options available include to either involve all the cytotechnologists or to select a subgroup of cytotechnologists who perform best with RPS. Presumably because the skills required for a cytotechnologist to perform RPS are different from those of full screening, RPS screening sensitivity appears to be independent of full screening sensitivity or of years of experience as a cytotechnologist 19 ; therefore, it appears that the best way to identify the cytotechnologists who perform best with RPS is to actually try it first with the entire laboratory and to base the selection on the actual RPS sensitivity of the individual cytotechnologists. Involvement of all (or at least of most) of the cytotechnologists working in a laboratory carries the advantages of distributing more equally the RPS task, which is considered a somewhat more ''intense'' task than regular full screening, and to expose more cytotechnologists to the hidden benefits of the learning associated with RPS, as stated earlier in the text, leading ultimately to improved full screening sensitivity.…”

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confidence: 99%

Rapid prescreening in gynecologic cytology

Auger

2011

Cancer Cytopathology

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Whenever I mention that our laboratory uses rapid prescreening (RPS) instead of the usual 10% random review to improve the detection of false-negative cases in gynecologic cytology, the usual response, with few exceptions, is an assortment of skeptical stares and polite smiles. It is indeed difficult to fathom that someone screening rapidly, that is, for less than 2 minutes, thereby covering only a fraction of the surface area of a slide, could uncover abnormalities not detected by another who has screened the same slide completely for 6 minutes or more. As counterintuitive as it seems, RPS works! Perhaps it is a practical application of the dictum ''two heads are better than one,'' which could be restated as ''four eyes are better than two.'' Indeed, 2 observers viewing independently the same object without knowing the other's opinion may focus on different aspects of that object and end up contributing additional or complementary findings. In the context of RPS, additional false-negative cases do get detected. The study by Tavares et al published in the current issue of Cancer Cytopathology adds strong data to the growing body of evidence that RPS is an excellent internal quality assurance method for improving the performance of gynecologic cytology. 1 Although a mandatory quality assurance technique by CLIA 88 in the United States, the 10% random review of negative gynecologic smears is renowned for its inefficiency and lack of statistical power to detect lowlevel achievement in primary screening. [2][3][4][5][6] Full manual rescreening of all negative gynecologic smears is too time consuming to be of practical value. Therefore, rapid screening, defined as the review of gynecologic smears in a shorter period than usual, generally less than 2 minutes, is an attractive alternative. Two types of rapid screening exist: rapid rescreening (RR) and RPS. Rapid rescreening consists of partial rescreening for a limited duration at low magnification (Â10) of slides previously reported as within normal limits or as inadequate. The rapid rescreener (usually a cytotechnologist who was not the initial screener of the smear) puts aside the smears probably containing missed abnormalities. These are then submitted to a full check by another cytotechnologist and/ or pathologist. Rapid rescreening is currently the preferred method for quality control for gynecologic cytology in the United Kingdom. The second type of rapid screening is RPS, which consists of rapidly screening all routine gynecological smears prior to the routine full screening (instead of doing it after the full screening, as in RR).

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Correlation of cytotechnologists' parameters with their performance in rapid prescreening of papanicolaou smears

Cited by 26 publications

References 20 publications

Improvement in the routine screening of cervical smears

Improvement in the routine screening of cervical smears

Quality Improvement in Cytology: Where Do We Go From Here?

Rapid prescreening in gynecologic cytology

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