Review of the Bethesda System atlas does not improve reproducibility or accuracy in the classification of atypical squamous cells of undetermined significance smears

The Bethesda System (TBS) and its accompanying atlas were developed to promote uniform diagnosis and reporting of cervical and vaginal cytology, especially with respect to borderline abnormal smears. The authors assessed whether group study of TBS atlas improves the reproducibility and accuracy of the cytopathologic diagnosis of equivocal Papanicolaou smears.

[1]  E. Trimble,et al.  Interim Guidelines for Management of Abnormal Cervical Cytology , 1994 .

[2]  L. Howell,et al.  Follow‐up of Papanicolaou smears diagnosed as atypical squamous cells of undetermined significance , 1996, Diagnostic cytopathology.

[3]  David R. Scott,et al.  Accuracy and interlaboratory reliability of human papillomavirus DNA testing by hybrid capture , 1995, Journal of clinical microbiology.

[4]  David R. Scott,et al.  Detection of human papillomavirus DNA in cytologically normal women and subsequent cervical squamous intraepithelial lesions. , 1999, Journal of the National Cancer Institute.

[5]  T. Rollason Blaustein’s Pathology of the Female Genital Tract , 2003, Springer New York.

[6]  D. Davey,et al.  Atypical squamous cells of undetermined significance: Interlaboratory comparison and quality assurance monitors , 1994, Diagnostic Cytopathology.

[7]  Jacob Cohen,et al.  Weighted kappa: Nominal scale agreement provision for scaled disagreement or partial credit. , 1968 .

[8]  W. Frable,et al.  Atypical squamous cells of undetermined significance: Correlative histologic and follow‐up studies from an academic medical center , 1997, Diagnostic cytopathology.

[9]  C. Brown,et al.  The 1988 Bethesda System for reporting cervical/vaginal cytologic diagnoses. , 1990, Acta cytologica.

[10]  K R Lee,et al.  Use of statistical analysis of cytologic interpretation to determine the causes of interobserver disagreement and in quality improvement , 1997, Cancer.

[11]  R. Hiatt,et al.  Identifying women with cervical neoplasia: using human papillomavirus DNA testing for equivocal Papanicolaou results. , 1999, JAMA.

[12]  R. Reiter,et al.  Problems Encountered With the Bethesda System: The University of Iowa Experience , 1991, Obstetrics and gynecology.

[13]  David R. Scott,et al.  Toward objective quality assurance in cervical cytopathology. Correlation of cytopathologic diagnoses with detection of high-risk human papillomavirus types. , 1994, American journal of clinical pathology.

[14]  M. Schiffman,et al.  Interim guidelines for management of abnormal cervical cytology. The 1992 National Cancer Institute Workshop. , 1994, JAMA.

[15]  S Wacholder,et al.  Epidemiologic evidence showing that human papillomavirus infection causes most cervical intraepithelial neoplasia. , 1993, Journal of the National Cancer Institute.

[16]  J. Robb The “ASCUS” swamp , 1994, Diagnostic cytopathology.

[17]  Diane Solomon,et al.  The Bethesda System for Reporting Cervical/Vaginal Cytologic Diagnoses , 1994, Springer US.

[18]  Diane Soloman,et al.  The 1988 Bethesda system for reporting cervical/vaginal cytologic diagnoses: Developed and approved at the national cancer institute workshop in Bethesda, MD, December 12–13, 1988 , 1989, Diagnostic cytopathology.