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Making the Most of Pap Testing
Alan M. Garber, MD, PhD
JAMA. 1998;279:240-241.
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Following dramatic newspaper and television accounts that clinical laboratories often failed to detect abnormal Papanicolaou (Pap) smears, Congress amended the Clinical Laboratory Improvement Act (CLIA) in 1988. CLIA '88 included provisions designed to reduce the false-negative rate for Pap smears by detecting and correcting deficiencies in laboratory procedures.1 Most laboratories have complied with the CLIA Pap smear requirements by taking a second look at ("rescreening") 10% of all Pap smears initially classified as "within normal limits."
CLIA-mandated rescreening may have stimulated laboratories to improve the quality and accuracy of testing. But when 90% of the slides read as normal are not rescreened, random rescreening can raise the overall sensitivity of testing by little. Newer approaches to reduce the false-negative rate, such as computer-based technologies to automate or assist in the interpretation of Pap smears, have the potential to do better. Automation might be expected to . . . [Full Text of this Article]
From the Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif, and Stanford University, Stanford, Calif.
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Timothy J. O'Leary, Miguel Tellado, Sally-Beth Buckner, Izzat S. Ali, Angelica Stevens, and Curtis W. Ollayos
JAMA. 1998;279(3):235-237.
ABSTRACT
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