Interobserver variability of cervical smears with squamous‐cell abnormalities: A philadelphia study

Department of Pathology and Laboratory Medicine, Hahnemann University, the Department of Pathology and Laboratory Medicine, Medical College Hospitals, the Department of Pathology and Laboratory Medicine, Hospital of University of Pennsylvania, the Department of Pathology, Lankenau Hospital, Philadelphia, and the Department of Pathology, Sacred Heart Hospital, Allentown, PA, Department of Laboratories, Mercy Hospital, Janesville, WI
Diagnostic Cytopathology (Impact Factor: 1.52). 11/1994; 11(4):352 - 357. DOI: 10.1002/dc.2840110408

ABSTRACT The reproducibility of reporting squamous lesions by the Bethesda System (TBS) was evaluated by distributing 20 slides to be classified among 5 panelists considered experts in the field of cytopathology. Four cases were chosen for their classic morphology and the remainder were foreseen to produce possible discrepancies within one diagnostic category. For 7/20 (35%) cases there was unanimous agreement. Participants disagreed within one category of magnitude for seven (35%) cases. In six (30%) cases there was a range of more than one category disagreement. However, additional written comments modifying TBS diagnoses often diminished the clinical significance of these discrepancies. We conclude that despite the important role of TBS in standardization of Pap smear reports, a great degree of subjectivity exists in classifying squamous abnormalities without “classic” morphology. The lack of reproducibility should be taken into account in cytology proficiency testing. Diagn Cytopathol 1994;11:352–357. © 1994 Wiley-Liss, Inc.

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