{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T01:44:20Z","timestamp":1790991860355,"version":"4.1.0"},"reference-count":15,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,10,22]],"date-time":"2019-10-22T00:00:00Z","timestamp":1571702400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100004917","name":"Cancer Prevention and Research Institute of Texas","doi-asserted-by":"publisher","award":["RP170668"],"award-info":[{"award-number":["RP170668"]}],"id":[{"id":"10.13039\/100004917","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["P01\u2010CA\u201082710\u201009"],"award-info":[{"award-number":["P01\u2010CA\u201082710\u201009"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diagnostic Cytopathology"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Although the Pap test has been the standard screening method for cervical precancer\/cancer detection, it has been criticized for having a relatively low sensitivity and a low reproducibility between pathologists. There is limited knowledge about inter\u2010rater agreement and what clinical and demographic factors are associated with disagreements between pathologists reading the same Pap smear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study aimed to assess inter\u2010 and intra\u2010 rater agreement of the Pap smear in 1619 cytologic slides with biopsy confirmation, using kappa statistics. Clinical and demographic factors associated with higher odds of inter\u2010rater agreement were also examined and stratified by histologic diagnosis grade.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Using a five grade classification system, the overall kappa statistics for total, inter\u2010rater, and intra\u2010rater samples were 0.62, 0.57, and 0.88 (unweighted) and 0.83, 0.81, and 0.95 (weighted), respectively. In stratified analyses by histologic grade, total kappas ranged from 0.40 (atypia) to 0.64 (human papilloma virus\/CIN 1). Factors such as referral for abnormal Pap test (diagnostic vs screening population), recruiting site, and parity were found to be associated with higher agreement between the two cytologic readings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We observed relatively higher levels of agreement compared with other studies. However, variability was considerable and agreement was generally moderate, suggesting that cervical screening test accuracy and reproducibility needs to be improved.<\/jats:p><\/jats:sec>","DOI":"10.1002\/dc.24325","type":"journal-article","created":{"date-parts":[[2019,10,22]],"date-time":"2019-10-22T16:16:49Z","timestamp":1571761009000},"page":"35-42","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Cervical cytology reproducibility and associated clinical and demographic factors"],"prefix":"10.1002","volume":"48","author":[{"given":"Hyunsoo","family":"Hwang","sequence":"first","affiliation":[{"name":"Department of Biostatistics and Data Science The University of Texas School of Public Health  Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Follen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology New York Medical College  Valhalla New York"},{"name":"Department of Obstetrics and Gynecology SUNY Downstate College of Medicine  Brooklyn New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martial","family":"Guillaud","sequence":"additional","affiliation":[{"name":"Department of Integrative Oncology BC Cancer Research Center  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Scheurer","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Section of Hematology\/Oncology Baylor College of Medicine  Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Calum","family":"MacAulay","sequence":"additional","affiliation":[{"name":"Department of Integrative Oncology BC Cancer Research Center  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Calum","family":"MacAulay","sequence":"additional","affiliation":[{"name":"Department of Integrative Oncology BC Cancer Research Center  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregg A.","family":"Staerkel","sequence":"additional","affiliation":[{"name":"Department of Pathology, Division of Pathology and Laboratory Medicine MD Anderson Cancer Center  Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"van Niekerk","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine BC Cancer Agency  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2505-0090","authenticated-orcid":false,"given":"Jose\u2010Miguel","family":"Yamal","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Data Science The University of Texas School of Public Health  Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,10,22]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/canjclin.49.1.8"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-132-10-200005160-00009"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.285.11.1500"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0b013e31804a8285"},{"key":"e_1_2_7_6_1","first-page":"49","article-title":"Intralaboratory reproducibility in cervical cytology. Results of the application of a 100\u2010slide set","volume":"37","author":"Confortini M","year":"1992","journal-title":"Acta Cytol"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.20681"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2303.2003.00061.x"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/0895-4356(94)00242-I"},{"key":"e_1_2_7_10_1","first-page":"92","article-title":"Interobserver reproducibility with LiquiPrepTM liquid\u2010based cervical cytology screening in a developing country","volume":"9","author":"Settakorn J","year":"2008","journal-title":"Asian Pac J Cancer Prev"},{"key":"e_1_2_7_11_1","first-page":"208","article-title":"Consistency of cytology diagnosis for cervical cancer between two laboratories","volume":"6","author":"Sriamporn S","year":"2005","journal-title":"Asian Pac J Cancer Prev"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.25667"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/001316446002000104"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1037\/h0026256"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.11613\/BM.2012.031"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19990825)87:4<178::AID-CNCR3>3.0.CO;2-1"}],"container-title":["Diagnostic Cytopathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/dc.24325","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/dc.24325","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/dc.24325","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,9]],"date-time":"2023-09-09T00:47:12Z","timestamp":1694220432000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/dc.24325"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,22]]},"references-count":15,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,1]]}},"alternative-id":["10.1002\/dc.24325"],"URL":"https:\/\/doi.org\/10.1002\/dc.24325","archive":["Portico"],"relation":{},"ISSN":["8755-1039","1097-0339"],"issn-type":[{"value":"8755-1039","type":"print"},{"value":"1097-0339","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10,22]]},"assertion":[{"value":"2019-07-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-09-24","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-10-22","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}