Internal quality control in an academic cytopathology laboratory for the introduction of a new reporting system for endometrial cytology
Autor: | Magdalini Stamataki, Christos Meristoudis, Dionysios Aninos, Petros Karakitsos, Abraham Pouliakis, Niki Margari, Ioannis Panayiotides |
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Rok vydání: | 2017 |
Předmět: |
Quality Control
medicine.medical_specialty Histology endometrial cytology Pathology and Forensic Medicine Hospitals University 03 medical and health sciences 0302 clinical medicine Cohen's kappa liquid based cytology medicine Humans Medical physics reproducibility Vaginal Smears Gynecology business.industry Carcinoma Reproducibility of Results General Medicine Clinical Laboratory Services Reference Standards 030224 pathology kappa statistics Endometrial Neoplasms Internal quality Endometrial cytology Cytopathology 030220 oncology & carcinogenesis Liquid-based cytology Female Clinical Laboratory Information Systems business Reporting system classification system Kappa Papanicolaou Test |
Zdroj: | Margari, N, Pouliakis, A, Aninos, D, Meristoudis, C, Stamataki, M, Panayiotides, I & Karakitsos, P 2017, ' Internal quality control in an academic cytopathology laboratory for the introduction of a new reporting system for endometrial cytology ', Diagnostic Cytopathology, vol. 45, no. 10, pp. 883-888 . https://doi.org/10.1002/dc.23787 |
ISSN: | 8755-1039 |
DOI: | 10.1002/dc.23787 |
Popis: | Background To evaluate reproducibility of a reporting system for endometrial cytology. Methods Cytologic slides from 49 patients, prepared via liquid based cytology, were blindly examined by five cytopathologists of various experience levels, applying a recently introduced reporting system as previously reported. The agreement among cytopathologists was evaluated via Kappa (κ) statistics and the Kendall's Coefficient of Variation (W); cytologic results were compared with the relevant histologic report. Results Substantial agreement among all five raters was found in the benign, ACE-L and malignant categories, fair agreement in inadequate and ACE-H categories, whereas only slight agreement in ACE-U. For the three more experienced cytopathologists, an almost perfect agreement was found in inadequate, benign, and ACE-L categories, substantial agreement in ACE-H and malignant categories and fair agreement in ACE-U category. Overall agreement for all five cytopathologists and for all categories was moderate, whereas it was very high for the three senior raters. Using the Kendall's test, both five cytopathologists (W = 0.81) and the three senior ones (W = 0.93) had very high agreement. Sensitivity: 83.33–92.59%, specificity: 83.33–94.74%, ROC area: 71.72–90.3%. Conclusion Application of appropriate statistical tests shows that integration of a new reporting cytologic system is effective with an overall accuracy around 90%. Both statistical tests applied disclosed lower agreement rates among both all five raters and the three most experienced ones in the intermediate categories constituting the gray zone, thus delineating the need for better training of cytopathologists to correctly identify diagnostic criteria for classification of a given case into these categories. |
Databáze: | OpenAIRE |
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