Characteristics and quality of Papanicolaou smears obtained by primary care clinicians using a single commercial laboratory.
Characteristics and quality of Papanicolaou smears obtained by primary care clinicians using a single commercial laboratory.
复制标题
初级保健临床医生使用单一商业实验室获得的巴氏涂片的特征和质量。
DOI：
10.1001/archfami.8.5.407
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发表时间：
1999
期刊：
影响因子：
--
通讯作者：
Qaqish,BF
中科院分区：
文献类型：
--
作者：
Curtis,P;Mintzer,M;Morrell,D;Resnick,JC;Hendrix,S;Qaqish,BF
资料与方法临床和细胞学数据来自21，833例巴氏涂片，由176名临床医生在7个月的时间内提交给一个大型商业实验室，结果妇产科医师、执业护士和医师助理提供筛查的妇女与家庭医生、内科医生和全科医生相比，年龄更小。与涂片”满意”或存在宫颈内细胞（作为足够取样的标志）的概率更高呈正相关的因素是患者年龄的增加、细胞刷的使用和妇产科医生的专业。与”有限”涂片相比，满意的涂片与细胞学异常的识别率增加无关。与此相反，涂片宫颈细胞表现出较高比例的异常与标本相比，没有这样的cells.Conclusions在获得巴氏涂片的性能之间存在差异的初级保健专业，但需要进一步澄清。细胞刷的使用和宫颈内细胞的存在是比满意涂片的实验室标准更真实地反映临床医生熟练程度的标准。
Background Few data are available on factors associated with the quality of Papanicolaou smears performed in primary care.Objective To identify the patterns and proficiency of cervical cancer screening among different primary care specialties.Materials and Methods Clinical and cytologic data from 21,833 Papanicolaou smears, submitted to a single large commercial laboratory by 176 clinicians during a 7-month period, were correlated with individual clinician and specialty characteristics according to indexes of specimen quality.Results Obstetrician-gynecologists, nurse practitioners, and physician assistants provided screening to a younger population of women compared with family physicians, internists, and general practitioners. Factors positively associated with a greater probability of a" satisfactory" smear or the presence of endocervical cells (as a marker of adequate sampling) were increasing patient age, use of the cytobrush, and the specialty of the obstetrician-gynecologist. Satisfactory smears were not associated with any increased identification of cytologic abnormalities compared with" limited" smears. In contrast, smears with endocervical cells showed a higher proportion of abnormalities compared with specimens without such cells.Conclusions Differences in the performance of obtaining Papanicolaou smears exist between primary care specialties, but need further clarification. The use of the cytobrush and the presence of endocervical cells are criteria that reflect clinician proficiency more realistically than the laboratory criterion of satisfactory smear.