{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T06:45:25Z","timestamp":1773297925678,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2014,8,13]],"date-time":"2014-08-13T00:00:00Z","timestamp":1407888000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cytopathology"],"published-print":{"date-parts":[[2016,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>An important internal quality control system used in the Cancer Prevention and Research Institute cytopathology laboratory in <jats:styled-content style=\"fixed-case\">F<\/jats:styled-content>lorence is the peer review procedure, based on the review of all abnormal cytological smears which routinely emerge. Peer review is an important training opportunity for all cytologists, especially for those with less experience. This article shows the results of the peer review procedure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Of the 63\u00a0754 Papanicolaou (Pap) smears screened in 2011, 1086 were considered to be abnormal [at least atypical squamous cells of undetermined significance (<jats:styled-content style=\"fixed-case\">ASC<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">US<\/jats:styled-content>+)] on primary screening (selected by a single cytologist) and were subjected to the peer review procedure. The overall performance of the laboratory's cytologists was evaluated using a multiple rater analysis and the comparison of each cytologist with the final diagnosis. Further, the agreement was assessed by means of <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>ohen's kappa and weighted kappa statistics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In general, a moderate\/substantial level of agreement between the ten cytologists and the final diagnoses was evident. Kappa values for each reader compared with the final diagnosis ranged from 0.54 to 0.69. The overall kappa value was 0.62 [95% confidence interval (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>), 0.58\u20130.66] and overall weighted kappa value was 0.76 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 0.74\u20130.79). The category\u2010specific agreement showed the lowest values for atypical squamous cells, cannot exclude high\u2010grade squamous intraepithelial lesion (<jats:styled-content style=\"fixed-case\">ASC<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">H<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In summary, peer review represents an important internal quality control in the evaluation and improvement of inter\u2010observer agreement and of the functioning of the laboratory as a whole. Multi\u2010head microscope sessions may improve particularly the reproducibility of borderline diagnoses and, above all, can be an important training contribution for cytologists.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cyt.12195","type":"journal-article","created":{"date-parts":[[2014,8,14]],"date-time":"2014-08-14T01:44:10Z","timestamp":1407980650000},"page":"35-42","source":"Crossref","is-referenced-by-count":9,"title":["Daily peer review of abnormal cervical smears in the assessment of individual practice as an additional method of internal quality control"],"prefix":"10.1111","volume":"27","author":[{"given":"M.","family":"Confortini","sequence":"first","affiliation":[{"name":"Cytopathology Unit ISPO \u2013 Cancer Prevention and Research Institute Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Di Stefano","sequence":"additional","affiliation":[{"name":"Cytopathology Unit ISPO \u2013 Cancer Prevention and Research Institute Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Biggeri","sequence":"additional","affiliation":[{"name":"Biostatistics Unit ISPO \u2013 Cancer Prevention and Research Institute Florence Italy"},{"name":"Department of Statistics, Informatics and Applications \u201cG. Parenti\u201d University of Florence Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Bulgaresi","sequence":"additional","affiliation":[{"name":"Cytopathology Unit ISPO \u2013 Cancer Prevention and Research Institute Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Di Claudio","sequence":"additional","affiliation":[{"name":"Cytopathology Unit ISPO \u2013 Cancer Prevention and Research Institute Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Grisotto","sequence":"additional","affiliation":[{"name":"Biostatistics Unit ISPO \u2013 Cancer Prevention and Research Institute Florence Italy"},{"name":"Department of Statistics, Informatics and Applications \u201cG. Parenti\u201d University of Florence Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Maddau","sequence":"additional","affiliation":[{"name":"Cytopathology Unit ISPO \u2013 Cancer Prevention and Research Institute Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Matucci","sequence":"additional","affiliation":[{"name":"Cytopathology Unit ISPO \u2013 Cancer Prevention and Research Institute Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Petreschi","sequence":"additional","affiliation":[{"name":"Cytopathology Unit ISPO \u2013 Cancer Prevention and Research Institute Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G. M.","family":"Troni","sequence":"additional","affiliation":[{"name":"Cytopathology Unit ISPO \u2013 Cancer Prevention and Research Institute Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Turco","sequence":"additional","affiliation":[{"name":"Cytopathology Unit ISPO \u2013 Cancer Prevention and Research Institute Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Foxi","sequence":"additional","affiliation":[{"name":"Cytopathology Unit ISPO \u2013 Cancer Prevention and Research Institute Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,8,13]]},"reference":[{"key":"e_1_2_5_2_1","volume-title":"IARC Handbooks of Cancer Prevention","author":"IARC working group on the evaluation of cancer preventive strategies Cervix cancer screening","year":"2005"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2303.1993.tb00069.x"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.287.16.2114"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.04.3661"},{"key":"e_1_2_5_6_1","first-page":"1","article-title":"Raccomandazioni per il controllo di qualit\u00e0 in citologia cervico\u2010vaginale","volume":"28","author":"GISCi","year":"2004","journal-title":"Epidemiol Prev"},{"key":"e_1_2_5_7_1","first-page":"535","article-title":"Quality control in cytopathology. 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