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Using the ASC:SIL ratio, human papillomavirus, and interobserver variability to assess and monitor cytopathology fellow training performance.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Chebib, Ivan Rao, Rema A. Wilbur, David C. Tambouret, Rosemary H.
Spatial Coverage	Massachusetts
Description	Author Affiliation: Chebib I ( Division of Cytopathology, James Homer Wright Pathology Laboratories, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.)
Abstract	BACKGROUND: The goal of this study was to assess objective measurements of cytopathology fellow performance during their training. METHODS: The authors examined cytopathology performance characteristics (the ratio of atypical squamous cells to squamous intraepithelial lesions [ASC:SIL], interobserver variability [IOV], high-risk human papillomavirus [hr-HPV]-positive atypical squamous cells of undetermined significance [ASC-US]) of cytopathology fellows and assessed whether they could be used as tools to further their education. RESULTS: The ASC:SIL ratio, the proportion of hr-HPV-positive ASC-US, and IOV were calculated for 5 consecutive cytopathology fellows. The average ASC:SIL ratio for the fellows was 1.15. The overall average Cohen κ-coefficient (κ-value) between fellow and cytopathologist interpretation was 0.75 (substantial agreement). The conditional κ-value for ASC-US only was higher for cases the fellows called ASC-US (0.70) than for cases the cytopathologist called ASC-US (0.60). Of the cases that were diagnosed as 'negative for intraepithelial lesion or malignancy' (NILM) by the fellow and ASC-US by the pathologist, 33.2% were positive for hr-HPV. This was higher than the expected frequency of hr-HPV-positive results in the NILM population, suggesting that the fellows were over-interpreting NILM in hr-HPV-positive cases that had cytologic features sufficient for an ASC-US interpretation. CONCLUSIONS: In this study, agreement was compared between trainee and cytopathologist to determine where a fellow's interpretation differed. With the use of IOV, the ASC:SIL ratio, and the percentage of hr-HPV-positive results in the NILM, ASC-US, and low-grade SIL categories, the authors attempted to outline objective assessments and areas of improvement for fellows before they enter independent practice.
File Format	HTM / HTML
ISSN	1934662X
Issue Number	11
Volume Number	121
e-ISSN	19346638
Journal	Cancer Cytopathology
Language	English
Publisher	Wiley-Blackwell
Publisher Date	2013-11-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Cytology Discipline Pathology Discipline Oncology Carcinoma In Situ Pathology Carcinoma, Squamous Cell Clinical Competence Pathology, Clinical Education Virology Hospitals, Teaching Humans Massachusetts Observer Variation Papillomaviridae Standards Journal Article
Content Type	Text
Resource Type	Article
Subject	Cancer Research Oncology

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1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
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3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
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