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To the Editor: In the study reported by Drs Stoler and Schiffman,¹ there was a surprisingly high degree of variability in the interpretation of results of histologic and cytologic cervical specimens. Considering the modest degree of reproducibility in these academic centers, this is surely a cause for humility. There are, however, inherent difficulties with such interpretations. Each cell in a cytologic preparation represents a point in a continuum from normal to neoplastic, but a diagnosis represents a summary of decisions about the significance of many cells at different stages. The reproducibility of a diagnosis of individual cells would be another interesting study of reproducibility.

This study was performed in an idealized setting, with no apparent time constraints on review. This difference from clinical practice may or may not improve the results. The authors speculate that this study "probably underestimate(s) the level of variability between groups of pathologists nationally," and that . . . [Full Text of this Article]

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Interobserver Reproducibility of Cervical Cytologic and Histologic Interpretations: Realistic Estimates From the ASCUS-LSIL Triage Study
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