Telemed J E Health - Assessment of static telecytological diagnoses' reproducibility in cervical smears prepared by means of liquid-based cytology.

Tópicos

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Resumo

JECTIVE: This study evaluated the accuracy and reproducibility of telecytological diagnoses proffered on the basis of digitized images from cervical smears prepared by means of liquid-based cytology.MATERIALS AND METHODS: Representative digital cytological images from a total of 404 cervical smears (benign, 135; atypical squamous cells of undetermined significance, 92; low-grade squamous intraepithelial lesion, 62; high-grade squamous intraepithelial lesion, 87; squamous cell carcinoma, 26; and adenocarcinoma, 2) were uploaded to the CytoTrainer e-learning telecytology platform (developed in the Department of Cytopathology, "ATTIKON" University General Hospital, Athens, Greece) with specific password-protected accounts and were reviewed remotely by four independent board-certified cytopathologists (checking round). Their reports were recorded and classified. After 12 and 24 months, the same representative digital images were transferred in random order to the same cytopathologists and were reviewed again (first and second review rounds, respectively). The cytopathologists' first and second round diagnoses were recorded and compared with their initial ones.RESULTS: Statistical evaluation of cytological diagnoses detected no significant difference in diagnostic accuracy among checking and review diagnoses. The overall interobserver agreement was almost perfect with values of 0.79-0.97, whereas intraobserver agreement ranged from almost perfect to perfect with values of 0.76-1 in all diagnostic rounds.CONCLUSIONS: Digital images of cervical smears can be used for rapid and accurate diagnosis, by diminishing turnaround times and improving small cytology departments' quality indices. Diagnoses made by using static telecytological systems can be as reliable as those made by using conventional microscopy, under the conditions that representative images are taken and that standard cytological diagnostic criteria are applied. Telecytology can be used as an alternative method for the cytologic diagnosis of cervical smears, particularly in quality assurance programs.

Resumo Limpo

jectiv studi evalu accuraci reproduc telecytolog diagnos proffer basi digit imag cervic smear prepar mean liquidbas cytologymateri method repres digit cytolog imag total cervic smear benign atyp squamous cell undetermin signific lowgrad squamous intraepitheli lesion highgrad squamous intraepitheli lesion squamous cell carcinoma adenocarcinoma upload cytotrain elearn telecytolog platform develop depart cytopatholog attikon univers general hospit athen greec specif passwordprotect account review remot four independ boardcertifi cytopathologist check round report record classifi month repres digit imag transfer random order cytopathologist review first second review round respect cytopathologist first second round diagnos record compar initi onesresult statist evalu cytolog diagnos detect signific differ diagnost accuraci among check review diagnos overal interobserv agreement almost perfect valu wherea intraobserv agreement rang almost perfect perfect valu diagnost roundsconclus digit imag cervic smear can use rapid accur diagnosi diminish turnaround time improv small cytolog depart qualiti indic diagnos made use static telecytolog system can reliabl made use convent microscopi condit repres imag taken standard cytolog diagnost criteria appli telecytolog can use altern method cytolog diagnosi cervic smear particular qualiti assur program

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