{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:10:58Z","timestamp":1783901458421,"version":"3.55.0"},"reference-count":10,"publisher":"Walter de Gruyter GmbH","issue":"2","license":[{"start":{"date-parts":[[2020,3,26]],"date-time":"2020-03-26T00:00:00Z","timestamp":1585180800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,3,26]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n p16\/Ki-67 dual immunocytochemical staining (DS) is considered easy to interpret if evaluators are properly trained, however, there is no consensus on what constitutes proper training. In the present study we evaluated a protocol for teaching DS evaluation on students inexperienced in cervical cytology.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Initial training on 40 DS conventional smears was provided by a senior cytotechnologist experienced in such evaluation. Afterwards, two students evaluated 118 cases. Additional training consisted mainly of discussing discrepant cases from the first evaluation and was followed by evaluation of new 383 cases. Agreement and accuracy of students\u2019 results were compared among the participants and to the results of the reference after both evaluations. We also noted time needed for evaluation of one slide as well as intra-observer variability of the teacher\u2019s results.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n At the end of the study, agreement between students and reference was higher compared to those after initial training (overall percent agreement [OPA] 81.4% for each student, kappa 0.512 and 0.527\n vs<\/jats:italic>\n . OPA 78.3% and 87.2%, kappa 0.556 and 0.713, respectively). However, accuracy results differed between the two students. After initial training sensitivity was 4.3% points and 2.9% points higher, respectively compared to the reference, while specificity was 30.6% points and 24.4% points lower, respectively, compared to the reference. At the end of the study, the sensitivity reached by one student was the same as that of the reference, while it was 2.6% points lower for the other student. There was a statistically significant difference in specificity between one student and the reference and also between students (16.7 and 15.1% points). Towards the end of the study, one student needed 5.2 min for evaluating one slide while the other needed 8.2 min. The intra-observer variability of the senior cytotechnologist was in the range of \u201cvery good\u201d in both arms of the study.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n In teaching DS evaluation, the students\u2019 progress has to be monitored using several criteria like agreement, accuracy and time needed for evaluating one slide. The monitoring process has to continue for a while after students reach satisfactory results in order to assure a continuous good performance. Monitoring of teacher\u2019s performance is also advisable.<\/jats:p>\n <\/jats:sec>","DOI":"10.2478\/raon-2020-0018","type":"journal-article","created":{"date-parts":[[2020,3,31]],"date-time":"2020-03-31T10:22:49Z","timestamp":1585650169000},"page":"201-208","source":"Crossref","is-referenced-by-count":5,"title":["Evaluation of the training program for p16\/ Ki-67 dual immunocytochemical staining interpretation for laboratory staff without experience in cervical cytology and immunocytochemistry"],"prefix":"10.2478","volume":"54","author":[{"given":"Veronika Kloboves","family":"Prevodnik","sequence":"first","affiliation":[{"name":"Department of Cytopathology, Institute of Oncology Ljubljana , Ljubljana , Slovenia"},{"name":"Faculty of Medicine, University of Ljubljana , Ljubljana , Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziva Pohar","family":"Marinsek","sequence":"additional","affiliation":[{"name":"Department of Cytopathology, Institute of Oncology Ljubljana , Ljubljana , Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janja","family":"Zalar","sequence":"additional","affiliation":[{"name":"Department of Cytopathology, Institute of Oncology Ljubljana , Ljubljana , Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hermina","family":"Rozina","sequence":"additional","affiliation":[{"name":"Department of Cytopathology, Institute of Oncology Ljubljana , Ljubljana , Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nika","family":"Kotnik","sequence":"additional","affiliation":[{"name":"Department of Experimental Allergology and Immunodermatology Oldenburg, Carl von Ossietzky Universit\u00e4t , Oldenburg , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tine","family":"Jerman","sequence":"additional","affiliation":[{"name":"Epidemiology and Cancer Registry, Institute of Oncology Ljubljana , Ljubljana , Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerneja","family":"Varl","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Ljubljana , Ljubljana , Slovenia"},{"name":"Department of Experimental Oncology, Institute of Oncology Ljubljana , Ljubljana , Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Urska","family":"Ivanus","sequence":"additional","affiliation":[{"name":"Epidemiology and Cancer Registry, Institute of Oncology Ljubljana , Ljubljana , Slovenia"},{"name":"Faculty of Medicine, University of Ljubljana , Ljubljana , Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2020,3,26]]},"reference":[{"key":"2026071213222482717_j_raon-2020-0018_ref_001_w2aab3b7c75b1b6b1ab2ab1Aa","doi-asserted-by":"crossref","unstructured":"Waldstr\u00f8m M, Christensen RK, \u00d8rnskov D. Evaluation of p16 INK4a\/Ki-67 dual stain in comparison with an mRNA human papillomavirus test on liquid-based cytology samples with low-grade squamous intraepithelial lesion. Cancer Cytopathol 2013; 121: 136-45. doi: 10.1002\/cncy.21233","DOI":"10.1002\/cncy.21233"},{"key":"2026071213222482717_j_raon-2020-0018_ref_002_w2aab3b7c75b1b6b1ab2ab2Aa","doi-asserted-by":"crossref","unstructured":"Wentzensen N, Fetterman B, Tougawa D, Shiffman M, Castle PE, Wood SN, et al. Interobserver reproducibility and accuracy of p16\/Ki67 dual-stain cytology in cervical cancer screening. Cancer Cytopathol 2014; 122: 914-20. doi: 10.1002\/cncy.21473","DOI":"10.1002\/cncy.21473"},{"key":"2026071213222482717_j_raon-2020-0018_ref_003_w2aab3b7c75b1b6b1ab2ab3Aa","doi-asserted-by":"crossref","unstructured":"Allia E, Ronco G, Coccia A, Luparia P, Macr\u00ec L, Fiorito C, et al. 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