Automated cervical cytology: meta-analyses of the performance of the AutoPap 300 QC System.

The objective of this study was to review current knowledge regarding the performance of the AutoPap 300 QC System (NeoPath Inc., Redmond, WA) for automated cervical cytology screening. To this goal, we identified all studies published in the English language that included the AutoPap 300 QC automated cervical cytology system. The studies were obtained from a MEDLINE search through October 1998; additional sources were identified through cross-referencing. Studies concerning the AutoPap 300 QC System containing complete data are presented descriptively. Meta-analyses about the performance of the AutoPap 300 QC System were performed. The central goal of the meta-analyses was to estimate the overall false-negative rate of the AutoPap 300 QC System when applied in either of the two following modalities: primary screening and quality control. Of the 14 studies concerning the performance of the AutoPap 300 QC System as a primary screening modality, four studies provided complete data about the number of abnormal slides, review rate, and number of slides selected. Meta-analysis of these four studies indicate sensitivities ranging between 85 and 100 percent. Regarding the performance of the AutoPap 300 QC System in the quality control modality, of the 14 studies reviewed, 5 studies provided complete data including the number of false-negatives, review rate, and number of slides selected. Meta-analysis of these five studies indicate an average sensitivity of the AutoPap 300 QC System applied as a rescreening modality of 37 percent (95% CI; 34-40 percent), with observed salvage ratios of between 3.5 and 5.6 when review rate of the AutoPap 300 QC System was set at 10 percent.