Renshaw A A, Dean B R, Cibas E S
Department of Pathology, Brigham & Women's Hospital, Boston, Mass 02115, USA.
Arch Pathol Lab Med. 1997 Sep;121(9):968-75.
To assess the value of receiver operating characteristic curves (ROCs) as a tool for improvement in the evaluation of cervicovaginal smear results.
We reviewed the results of cervicovaginal smear interpretation for 1 year by 10 different cytopathologists working in the same laboratory (total number of cases, 45,356) and compared them with results of histologic evaluation of corresponding biopsies (n = 2090, 4.6%), the latter taken to be the gold standard. Receiver operating characteristic curves were generated for the laboratory as a whole and for individual cytopathologists.
Analysis of these receiver operating characteristic curves was surprisingly informative. They showed that cytopathologists with different diagnostic thresholds could be distinguished from each other. A difference in diagnostic threshold could be distinguished from a difference in diagnostic accuracy.
We conclude that while receiver operating characteristic curves for cervicovaginal smear interpretation have limitations, the results can be used for quality improvement.
