DIFFERENCES BETWEEN FALSE-NEGATIVE AND TRUE-POSITIVE PAPANICOLAOU SMEARS ON PAPNET-ASSISTED REVIEW

This study explored whether there were differences between false-negat ive and true-positive Papanicolaou (Pap) smears in the number of abnor mal images on a Papnet-assisted review The degree of agreement between cytotechnologists over Papnet tile status (normal/abnormal) was asses sed. False-negative and true-positive Pap smears preceding a histologi c diagnosis of carcinoma in situ were scanned by Papnet, and the resul ting digital images and slides were assessed independently by three cy totechnologists. The median number of abnormal tiles was 7.3 for false -negative slides and 29.7 for true-positive slides. Three-way agreemen t between cytotechnologists was better for true-positive slides (kappa , 0.60) than for false-negative slides (kappa, 0.47). These results co nfirm intrinsic differences between false-negative and true-positive P ap smears. The fair to good agreement beyond chance on tile status ind icates that a cautious approach should be adopted if digital image rev iew? is performed in a judgemental manner Diagn. Cytopathol. 1998;19:1 38-140. (C) 1998 Wiley-Liss, Inc.