Hawthorne C, Greening S E, Grassia R, Tiesi C, Weidmann J, Bibbo M
Cytopathology Laboratory, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Acta Cytol. 1997 Jan-Feb;41(1):160-5. doi: 10.1159/000332318.
To determine whether the Pathfinder Cytology System facilitates comparison of initial student diagnoses to rescreener diagnoses; provides a platform for collection, storage and retrieval of data on student screening performance; and generates a student screening "score."
Using two CompuCyte Pathfinder units networked to a PC server and printer, eight cytotechnology students prescreened 1,224 gynecologic cases and entered their results into the Pathfinder database. Five staff cytotechnologists rescreened the cases and entered their diagnoses. The database containing the initial and rescreen diagnoses were transferred to a modified scoring grid that computed a screening "score" for each of the students.
Student diagnoses matched cytotechnologist target diagnoses in 1,107 to 1,224 total cases (90.4%). Of these 1,107 cases, 996 (81.3%) were reported as "within normal limits" (negative) by both student and cytotechnologist, and 111 (9.1%) were target diagnosed as abnormal (atypical squamous cells of undetermined significance [ASCUS] or above) by both student and cytotechnologist. Of 117 remaining cases, 112 (9.2%) were considered minor discrepancies (one-step discrepancy--e.g., benign cell change-reactive vs. ASCUS--favor reactive), and 5 (0.4%) were considered significant discrepancies (two or more diagnostic categories of difference between student and cytotechnologist-within normal limits vs. low grade squamous intraepithelial lesion). The modified scoring grid developed by CompuCyte for this study was able to compute a numerical score for each student.
Our preliminary assessment indicated that Pathfinder will facilitate evaluation of student performance. The system shows potential for eliminating the "paper trail" and manual dotting required for traditional student evaluation and, with the addition of a scoring program, may be standardized for use in both educational and clinical settings.
确定Pathfinder细胞学系统是否有助于比较学生的初始诊断与复查诊断；是否能提供一个收集、存储和检索学生筛查表现数据的平台；以及是否能生成学生筛查“分数”。
使用两台联网到个人电脑服务器和打印机的CompuCyte Pathfinder设备，八名细胞技术专业学生对1224例妇科病例进行了初筛，并将结果录入Pathfinder数据库。五名细胞技术专业工作人员对这些病例进行了复查并录入他们的诊断结果。包含初始诊断和复查诊断的数据库被传输到一个经过修改的评分网格中，该网格为每个学生计算出一个筛查“分数”。
在总共1224例病例中，学生诊断与细胞技术专业人员的目标诊断相符的有1107例（90.4%）。在这1107例病例中，996例（81.3%）学生和细胞技术专业人员均报告为“在正常范围内”（阴性），111例（9.1%）目标诊断为异常（意义不明确的非典型鳞状细胞[ASCUS]及以上）。在其余117例病例中，112例（9.2%）被认为是小差异（一步差异——例如，良性细胞改变——反应性与ASCUS——倾向于反应性），5例（0.4%）被认为是显著差异（学生和细胞技术专业人员之间的诊断类别差异为两个或更多——正常范围内与低级别鳞状上皮内病变）。CompuCyte为该研究开发的经过修改的评分网格能够为每个学生计算出一个数值分数。
我们的初步评估表明，Pathfinder将有助于评估学生的表现。该系统显示出消除传统学生评估所需的“书面记录”和手工打点的潜力，并且通过添加评分程序，可能会标准化以便在教育和临床环境中使用。
