ArticleCancer cytopathology2022
Inter- and intraobserver agreement in whole-slide digital ThinPrep samples of low-grade squamous lesions of the cervix uteri with known high-risk HPV status: A multicentric international study.
Article in Cancer cytopathology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 15 citations in OpenAlex.
- Application and Impact of Quality Assurance Dashboards in Cytology Laboratories-The CytoLog Application.Cytopathology : official journal of the British Society for Clinical Cytology · 2026Article
- A Unified Deep Learning Framework for Instance Segmentation Across Diverse Cytological Stains.Cytopathology : official journal of the British Society for Clinical Cytology · 2026Article
- Genotype-Specific HPV E6/E7 mRNA Triage for Risk Stratification in HPV DNA-Positive Women with ASC-US/LSIL: A Population-Based Tromsø Cohort.Pathogens (Basel, Switzerland) · 2026Article
- Cervical Cytology and HPV16/18/45 mRNA Co-Testing Improve Risk Stratification in Routine Clinical Practice.Cancers · 2026Article
- Human Papillomavirus Primary Screening and Collaboration in Quality Assurance Work between Laboratories.Acta cytologica · 2026Review
- Validation of AI-assisted ThinPrep® Pap test screening using the GeniusJournal of pathology informatics · 2024Article
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Authors and funding
19 authors at 17 institutions in 15 countries.
Funding
Abstract
backgroundHigh-risk human papilloma virus (HR HPV) testing and liquid-based cytology are used for primary cervical screening. Digital cytology, based on whole-slide scanned samples, is a promising technique for teaching and diagnostic purposes. The aim of our study was to evaluate the interobserver and intraobserver variation in low-grade squamous lesions, HR HPV status bias, and the use of whole-slide scanned digital cervical cytology slides.
methodsFifteen expert cytopathologists evaluated 71 digitalized ThinPrep slides (31 atypical squamous cells of undetermined significance [ASC-US], 21 negative for intraepithelial lesion or malignancy, and 19 low-grade squamous intraepithelial lesion cases). HR HPV data were accessible only in the second round.
resultsIn interobserver analysis, Kendall's coefficient of concordance was 0.52 in the first round and 0.58 in the second round. Fleiss' kappa values were 0.29 in the first round and 0.31 in the second round. In the ASC-US category, Fleiss kappa increased from 0.19 to 0.22 in the second round and the increase was even higher expressed by Kendall's coefficient: from 0.42 to 0.52. In intraobserver analysis, personal scores were higher in the second round.
conclusionsThe interobserver and intraobserver variability in low-grade squamous lesions was within fair agreement values in the present study, in line with previous works. The comparison of two rounds showed that expert cytopathologists are generally unbiased by the knowledge of HR HPV data, but that being informed of the HR HPV status leads to a better agreement. Stain quality and back discomfort were highlighted as factors affecting digital cytopathology use.
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