Cervical biopsy sampling variability in ALTS

Daron Gale Ferris, Mark S. Litaker

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objective. To determine histologic sampling variability among clinical center colposcopists and quality control reviewers in the Atypical Squamous Cells of Undetermined Significance/Low-grade Squamous Intraepithelial Lesion Triage Study. Materials And Methods. Clinical center colposcopists and quality control reviewers independently indicated need for biopsy, number of biopsies needed, and optimal biopsy location on customized computer software and digitized colposcopic images while examining subjects or monitoring colposcopists in the Atypical Squamous Cells of Undetermined Significance/Low-grade Squamous Intraepithelial Lesion Triage Study. Results were compared using percentages of agreement, κ statistics, McNemar, and paired t tests. Results. Colposcopists and reviewers agreed whether a cervical biopsy was indicated for 2,631 (72.9%) of 3,610 evaluable subjects and 415 (91.6%) of 453 subjects with cervical intraepithelial neoplasia 2 or worse by histologic diagnosis. Only 3 of 41 colposcopists indicated 20% or greater of their biopsy sites to be more than 10 mm from reviewers' recommended sites. The mean of the greatest colposcopist-to-reviewer biopsy site distance was significantly greater than the mean maximum distance between reviewers' biopsy sites (14.9 vs 12.2 mm, p < .0001, respectively). Colposcopists indicated a significantly greater number of biopsy sites compared with consensus of reviewers (p < .0001). Conclusions. When cervical cancer precursors are present in women with minor cytologic abnormalities, most colposcopists obtain a biopsy. However, biopsy site placement can vary considerably. Only a minority of colposcopists sample significantly beyond recommended areas and less biopsy site variability occurs among experts.

Original languageEnglish (US)
Pages (from-to)163-168
Number of pages6
JournalJournal of Lower Genital Tract Disease
Volume15
Issue number2
DOIs
StatePublished - Apr 1 2011

Fingerprint

Biopsy
Triage
Quality Control
Cervical Intraepithelial Neoplasia
Uterine Cervical Neoplasms
Software

Keywords

  • ALTS
  • cervical biopsy
  • colposcopy
  • histology
  • quality control

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Cervical biopsy sampling variability in ALTS. / Ferris, Daron Gale; Litaker, Mark S.

In: Journal of Lower Genital Tract Disease, Vol. 15, No. 2, 01.04.2011, p. 163-168.

Research output: Contribution to journalArticle

@article{3f00d0f375a1416fa94f6233763f1b13,
title = "Cervical biopsy sampling variability in ALTS",
abstract = "Objective. To determine histologic sampling variability among clinical center colposcopists and quality control reviewers in the Atypical Squamous Cells of Undetermined Significance/Low-grade Squamous Intraepithelial Lesion Triage Study. Materials And Methods. Clinical center colposcopists and quality control reviewers independently indicated need for biopsy, number of biopsies needed, and optimal biopsy location on customized computer software and digitized colposcopic images while examining subjects or monitoring colposcopists in the Atypical Squamous Cells of Undetermined Significance/Low-grade Squamous Intraepithelial Lesion Triage Study. Results were compared using percentages of agreement, κ statistics, McNemar, and paired t tests. Results. Colposcopists and reviewers agreed whether a cervical biopsy was indicated for 2,631 (72.9{\%}) of 3,610 evaluable subjects and 415 (91.6{\%}) of 453 subjects with cervical intraepithelial neoplasia 2 or worse by histologic diagnosis. Only 3 of 41 colposcopists indicated 20{\%} or greater of their biopsy sites to be more than 10 mm from reviewers' recommended sites. The mean of the greatest colposcopist-to-reviewer biopsy site distance was significantly greater than the mean maximum distance between reviewers' biopsy sites (14.9 vs 12.2 mm, p < .0001, respectively). Colposcopists indicated a significantly greater number of biopsy sites compared with consensus of reviewers (p < .0001). Conclusions. When cervical cancer precursors are present in women with minor cytologic abnormalities, most colposcopists obtain a biopsy. However, biopsy site placement can vary considerably. Only a minority of colposcopists sample significantly beyond recommended areas and less biopsy site variability occurs among experts.",
keywords = "ALTS, cervical biopsy, colposcopy, histology, quality control",
author = "Ferris, {Daron Gale} and Litaker, {Mark S.}",
year = "2011",
month = "4",
day = "1",
doi = "10.1097/LGT.0b013e3181f2ddf3",
language = "English (US)",
volume = "15",
pages = "163--168",
journal = "Journal of Lower Genital Tract Disease",
issn = "1089-2591",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Cervical biopsy sampling variability in ALTS

AU - Ferris, Daron Gale

AU - Litaker, Mark S.

PY - 2011/4/1

Y1 - 2011/4/1

N2 - Objective. To determine histologic sampling variability among clinical center colposcopists and quality control reviewers in the Atypical Squamous Cells of Undetermined Significance/Low-grade Squamous Intraepithelial Lesion Triage Study. Materials And Methods. Clinical center colposcopists and quality control reviewers independently indicated need for biopsy, number of biopsies needed, and optimal biopsy location on customized computer software and digitized colposcopic images while examining subjects or monitoring colposcopists in the Atypical Squamous Cells of Undetermined Significance/Low-grade Squamous Intraepithelial Lesion Triage Study. Results were compared using percentages of agreement, κ statistics, McNemar, and paired t tests. Results. Colposcopists and reviewers agreed whether a cervical biopsy was indicated for 2,631 (72.9%) of 3,610 evaluable subjects and 415 (91.6%) of 453 subjects with cervical intraepithelial neoplasia 2 or worse by histologic diagnosis. Only 3 of 41 colposcopists indicated 20% or greater of their biopsy sites to be more than 10 mm from reviewers' recommended sites. The mean of the greatest colposcopist-to-reviewer biopsy site distance was significantly greater than the mean maximum distance between reviewers' biopsy sites (14.9 vs 12.2 mm, p < .0001, respectively). Colposcopists indicated a significantly greater number of biopsy sites compared with consensus of reviewers (p < .0001). Conclusions. When cervical cancer precursors are present in women with minor cytologic abnormalities, most colposcopists obtain a biopsy. However, biopsy site placement can vary considerably. Only a minority of colposcopists sample significantly beyond recommended areas and less biopsy site variability occurs among experts.

AB - Objective. To determine histologic sampling variability among clinical center colposcopists and quality control reviewers in the Atypical Squamous Cells of Undetermined Significance/Low-grade Squamous Intraepithelial Lesion Triage Study. Materials And Methods. Clinical center colposcopists and quality control reviewers independently indicated need for biopsy, number of biopsies needed, and optimal biopsy location on customized computer software and digitized colposcopic images while examining subjects or monitoring colposcopists in the Atypical Squamous Cells of Undetermined Significance/Low-grade Squamous Intraepithelial Lesion Triage Study. Results were compared using percentages of agreement, κ statistics, McNemar, and paired t tests. Results. Colposcopists and reviewers agreed whether a cervical biopsy was indicated for 2,631 (72.9%) of 3,610 evaluable subjects and 415 (91.6%) of 453 subjects with cervical intraepithelial neoplasia 2 or worse by histologic diagnosis. Only 3 of 41 colposcopists indicated 20% or greater of their biopsy sites to be more than 10 mm from reviewers' recommended sites. The mean of the greatest colposcopist-to-reviewer biopsy site distance was significantly greater than the mean maximum distance between reviewers' biopsy sites (14.9 vs 12.2 mm, p < .0001, respectively). Colposcopists indicated a significantly greater number of biopsy sites compared with consensus of reviewers (p < .0001). Conclusions. When cervical cancer precursors are present in women with minor cytologic abnormalities, most colposcopists obtain a biopsy. However, biopsy site placement can vary considerably. Only a minority of colposcopists sample significantly beyond recommended areas and less biopsy site variability occurs among experts.

KW - ALTS

KW - cervical biopsy

KW - colposcopy

KW - histology

KW - quality control

UR - http://www.scopus.com/inward/record.url?scp=79955052895&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79955052895&partnerID=8YFLogxK

U2 - 10.1097/LGT.0b013e3181f2ddf3

DO - 10.1097/LGT.0b013e3181f2ddf3

M3 - Article

C2 - 21169866

AN - SCOPUS:79955052895

VL - 15

SP - 163

EP - 168

JO - Journal of Lower Genital Tract Disease

JF - Journal of Lower Genital Tract Disease

SN - 1089-2591

IS - 2

ER -