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Interobserver variability of cervical cytology in HIV ‐infected women
Author(s) -
Heard I.,
Potard V.,
Bergeron C.,
Cartier I.,
Costagliola D.
Publication year - 2015
Publication title -
cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.512
H-Index - 48
eISSN - 1365-2303
pISSN - 0956-5507
DOI - 10.1111/cyt.12176
Subject(s) - medicine , kappa , reproducibility , cytology , liquid based cytology , human immunodeficiency virus (hiv) , gynecology , cervical screening , papanicolaou stain , concordance , confidence interval , obstetrics , cohen's kappa , cervical cancer , pathology , cancer , immunology , philosophy , linguistics , statistics , mathematics , machine learning , computer science
Objectives Our objectives were to determine the reproducibility of cytological specimen interpretation between two pathologists in human immunodeficiency virus ( HIV )‐infected women (from the VIHGY , ANRS CO 17 study of human papillomavirus genital pathology among HIV ‐positive women) and to analyse the improvement, if any, between conventional and liquid‐based cytology ( LBC ) interpretations. Materials and methods A sample of all abnormal and 40% of randomly selected normal Papanicolaou (Pap) tests was randomly ordered and read blindly by a second pathologist using the revised Bethesda terminology 2001. For both conventional and liquid‐based preparations, unweighted and Cicchetti–Allison‐weighted kappa and their 95% confidence intervals ( CI s) were calculated. Kappa values were then compared using the Altman rule to classify the reproducibility of cytological specimen interpretation. Results Two hundred and seventy‐seven conventional Pap tests were reviewed, including 79 abnormal and 10 unsatisfactory results. Overall agreement between the two observers was 78%, with an estimated Cicchetti–Allison‐weighted kappa of 0.69 (95% CI , 0.61–0.77). The corresponding values for the 268 LBC s, including 123 abnormal and two unsatisfactory results, were 84% and 0.82 (95% CI , 0.76–0.87), respectively. The reproducibility of LBC interpretations was significantly higher than that of conventional preparations ( P = 0.009) and, for both laboratories, the percentages of unsatisfactory results were significantly lower for LBC . Conclusion In HIV ‐infected women in the combination antiretroviral therapy era, the strength of agreement was better for LBC s than for conventional preparations, with a lower percentage of unsatisfactory results. When available, LBC should be preferred because of its higher reproducibility.