{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T22:53:08Z","timestamp":1782255188030,"version":"3.54.5"},"reference-count":31,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2016,12,28]],"date-time":"2016-12-28T00:00:00Z","timestamp":1482883200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100005278","name":"Universidad de Antioquia","doi-asserted-by":"publisher","award":["CPT\u20109889\u20101208"],"award-info":[{"award-number":["CPT\u20109889\u20101208"]}],"id":[{"id":"10.13039\/501100005278","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cytopathology"],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To identify factors that influence the inter\u2010observer reproducibility of the routine, conventional Pap smear cytology (Pap smear test) in a network of certificated laboratories in a middle\u2010income Latin American country.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty\u2010six laboratories provided each an average of 26 negative for malignancy (<jats:styled-content style=\"fixed-case\">NILM<\/jats:styled-content>) and high\u2010grade squamous intraepithelial lesion (<jats:styled-content style=\"fixed-case\">HSIL<\/jats:styled-content>) Pap smears. An external panel reviewed the slides. The kappa index and multilevel logistic regression were used to estimate the reproducibility and odds ratios (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>) of a false result with 95% confidence intervals (95%<jats:styled-content style=\"fixed-case\"> CI<\/jats:styled-content>), respectively. Results are presented for laboratories that collect (collector laboratories) and do not collect (non\u2010collector laboratories) samples.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The agreements ranged widely (median kappa 0.51, range 0.16\u20130.70). The overall false\u2010positive (<jats:styled-content style=\"fixed-case\">FP<\/jats:styled-content>) and false\u2010negative (<jats:styled-content style=\"fixed-case\">FN<\/jats:styled-content>) rates were 31% (95%<jats:styled-content style=\"fixed-case\"> CI<\/jats:styled-content> 27\u201335) and 11% (95%<jats:styled-content style=\"fixed-case\"> CI<\/jats:styled-content> 7\u201317). Among collector laboratories (<jats:italic>N<\/jats:italic> = 14), a bigger sample collection volume decreased the probability of a <jats:styled-content style=\"fixed-case\">FP<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u2010adjusted 0.05, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.02\u20130.1) whereas the number of quality defects (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u2010adjusted 1.67, 95%<jats:styled-content style=\"fixed-case\"> CI<\/jats:styled-content> 1.25\u20132.24), high workload (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u2010adjusted 5.52, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 3.85\u20137.92) and collection by cytotechnologists (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u2010adjusted 1.28, 95%<jats:styled-content style=\"fixed-case\"> CI<\/jats:styled-content> 1.15\u20131.42) or health professionals (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u2010adjusted 2.26, 95%<jats:styled-content style=\"fixed-case\"> CI<\/jats:styled-content> 2.04\u20132.49) instead of nursing assistants increased it. Among non\u2010collector laboratories (<jats:italic>N<\/jats:italic> = 9), the <jats:styled-content style=\"fixed-case\">FP<\/jats:styled-content> rate increased with the number of quality defects (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u2010adjusted 1.86, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.06\u20133.26) but decreased if the samples were collected by health professionals instead of nursing assistants (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u2010adjusted 0.37, 95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.17\u20130.80). No significant associations were observed for <jats:styled-content style=\"fixed-case\">FN<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Staff in charge of cervical sampling significantly determined the reproducibility of the Pap smear test, but this depended on whether the laboratory collects samples or read samples collected elsewhere.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cyt.12410","type":"journal-article","created":{"date-parts":[[2016,12,28]],"date-time":"2016-12-28T10:23:13Z","timestamp":1482920593000},"page":"192-202","source":"Crossref","is-referenced-by-count":11,"title":["Factors related to inter\u2010observer reproducibility of conventional Pap smear cytology: a multilevel analysis of smear and laboratory characteristics"],"prefix":"10.1111","volume":"28","author":[{"given":"A.","family":"Baena","sequence":"first","affiliation":[{"name":"Infection and Cancer Group School of Medicine Universidad de Antioquia Medellin Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Guevara","sequence":"additional","affiliation":[{"name":"Infection and Cancer Group School of Medicine Universidad de Antioquia Medellin Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Almonte","sequence":"additional","affiliation":[{"name":"Prevention and Implementation Group International Agency for Research on Cancer Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Arias\u2010Stella","sequence":"additional","affiliation":[{"name":"Institute of Pathology and Molecular Biology, Arias Stella Lima Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Sasieni","sequence":"additional","affiliation":[{"name":"Wolfson Institute of Preventive Medicine Barts and The London School of Medicine and Dentistry Queen Mary University of London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. 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