Reproducibility of Telecytology Diagnosis of Cervical Smears in a Quality Assurance Program: The Georgian Experience

Objective:The study evaluated the reproducibility of telecytology diagnosis of cervical smears on a randomly selected 50 cases under the conditions of Georgia. Materials and Methods:Fifty cervical smears (benign, 14; atypical squamous cells of undetermined significance ASCUS, 14; low-grade squamous intraepithelial lesion LSIL, 10; high-grade squamous intraepithelial lesion HSIL, 12) were selected. The digital images were captured at a maximum resolution of 2048×1536 pixels and transmitted by electronic mail. Diagnosis of glass slides and digital images was done independently in a double-blind manner by three cytologists, versus the diagnosis of digital images followed by diagnosis of glass slides 3 months later. The procedure was repeated after 3 months. Results:Diagnoses were recorded as benign, ASCUS, LSIL, and HSIL. Diagnostic accuracy and interobserver reproducibility were analyzed using an interclass correlation coefficient, which revealed good interobserver agreement for the first (0.82) and second (0.68) glass slide diagnoses and the first (0.80) and second (0.66) digital image diagnoses. The kappa values for interobserver variation between first and second glass slide diagnoses and first and second digital image diagnoses showed good to excellent agreement. Conclusions:Digital images are suitable substitutes for glass slides; telecytology can be used as an alternative method for the cytologic diagnosis of cervical smears, particularly in quality assurance programs.