Telecytology: Intraobserver and interobserver reproducibility in the diagnosis of cervical-vaginal smears

Patricia M. Alli, Curtis W. Ollayos, Lester D. Thompson, Iqbal Kapadia, Daniel R. Butler, Bruce H. Williams, Dorothy L. Rosenthal, Timothy J. O’Leary

Research output: Contribution to journalArticlepeer-review


Telecytologic diagnosis of cervical-vaginal smears is potentially useful because it could allow more efficient use of cytopathologist resources and expertise. A pathologist in one location could, in principle, review cytotechnologists’ findings using a video display hundreds or thousands of miles away. Currently, bandwidth restrictious limit practical implementation of such a system to review of fields that had been selected for review by the cytotechnologist. The purpose of our investigation was to evaluate how well this type of review correlates with a review in which the entire slide is available for examination by the pathologist. We prospectively selected 100 consecutive cervical-vaginal smears over an 11-day period in August 1999. For each smear, 4 to 12 fields containing abnormal cells from each slide were digitally imaged. Each of 3 pathologists reviewed all digitized images and all glass slides. Diagnoses based on selected digitized images were compared with those based on conventional pathologist review. The κ statistic, a measure of chance-corrected agreement (reproducibility), was calculated in each setting. Overall, intraobserver and interobserver reproducibility of cervical-vaginal smear diagnoses is fair to excellent. The use of remote digital images for pathologist review did not introduce large (2-step) diagnostic disagreements. The disagreement between a pathologist’s glass slide and digital diagnoses is less than that for different pathologists reviewing glass slides, although interobserver differences were even greater in the interpretation of digital images.

Original languageEnglish (US)
Pages (from-to)1318-1322
Number of pages5
JournalHuman pathology
Issue number12
StatePublished - Dec 1 2001


  • Cervical-vaginal smears
  • Diagnostic reproducibility
  • Pap smear
  • Telecytology

ASJC Scopus subject areas

  • Pathology and Forensic Medicine


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