Observer variation in cytologic grading for cervical dysplasia of Papanicolaou smears with the PAPNET testing system

• Published in: Cancer 1999-08, Vol.87 (4), p.178-183
• Main Authors: Doornewaard, Heleen, van der Schouw, Yvonne T., van der Graaf, Yolanda, Bos, Anita B., van den Tweel, Jan G.
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Cervical Intraepithelial Neoplasia - pathology; cervical smear; Diagnosis, Differential; Female; Genital system. Mammary gland; Humans; image analysis; Image Interpretation, Computer-Assisted; Investigative techniques, diagnostic techniques (general aspects); Mass Screening - methods; Medical sciences; Neural Networks (Computer); Observer Variation; Papanicolaou Test; PAPNET Testing System; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Uterine Cervical Dysplasia - pathology; Uterine Cervical Neoplasms - pathology; Vaginal Smears - instrumentation; Vaginal Smears - methods; Vaginal Smears - statistics & numerical data
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/(SICI)1097-0142(19990825)87:4<178::AID-CNCR3>3.0.CO;2-1

BACKGROUND To assess the interobserver and intraobserver variation of Papanicolaou (Pap) smear screening with the computer‐assisted (neural network based) PAPNET Testing System in diagnosing cervical smear abnormalities, results of agreement were compared with the interobserver and intraobserver variation of conventional smear analysis. METHODS Cervical smears obtained from women in 1996 were reevaluated both by conventional light microscopy and with use of the PAPNET Testing System by the same four investigators, and results were compared with the original screening diagnoses obtained by both methods. RESULTS The interobserver results for epithelial abnormalities (the degree of agreement between the cytologists), characterized by weighted kappa statistics, were 0.71 (95% CI: 0.68–0.73) for PAPNET screening and 0.69 (95% CI: 0.66–0.72) for conventional screening. No significant differences were found among the individual results obtained by the four cytotechnologists (intraobserver variation) with conventional screening versus PAPNET reviewing. CONCLUSIONS Pap smear grading with the PAPNET Testing System has interobserver and intraobserver variation similar to that of conventional screening of Pap smears in routine use. Cancer (Cancer Cytopathol) 1999;87:178–83. © 1999 American Cancer Society. When PAPNET‐assisted screening was compared with conventional Pap smear analysis, no differences in interobserver and intraobserver variation were found.