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CAP Home > CAP Accreditation and Laboratory Improvement > Gynecologic Cytology PT Program (PAP PT) > proficiency_testing/pap_pt/general_information.html > Grading Proficiency Testing Slides

  Grading Proficiency
  Testing Slides

 

Published September 5, 2006

Per CLIA §493.945, point values for slides are based on the significance of the relationship of the interpretation to a clinical condition and whether the participant is a pathologist (technical supervisor) or cytotechnologist

The four response categories as defined are:

  1. Unsatisfactory
    • Due to scant cellularity, air drying, obscuring material such as blood, inflammatory cells or lubricant
  2. Negative
    • Includes normal, infectious agents other than Human Papilloma Virus (ie, Trichomonas Vaginalis, changes or morphology consistent with Candida sp., Actinomyces spp. Or Herpes simplex virus)
    • Repair/reactive changes
  3. LSIL (Low Grade Squamous Intraepithelial Lesion)
    • Includes Human Papillomavirus changes and Mild Dysplasia
  4. HSIL and Carcinoma (High Grade Squamous Intraepithelial Lesion)
    • Includes Moderate Dysplasia/ CIN2 and Severe Dysplasia–Carcinoma in situ/CIN3
    • Squamous Cell Carcinoma
    • Adenocarcinoma and other malignant neoplasms

A participant answer to the correct series (A, B, C, D) is considered correct and awarded a maximum of 10 points. For example, if the Reference diagnosis (correct answer) is Negative for Intraepithelial Lesion or Malignancy and the participant’s answer is Repair or Trichomonas, it is considered correct to the B series for 10 points. There is a maximum of –5 points for an incorrect response. For example, if the Reference diagnosis is HSIL (category D) and the examinee response is Negative (category B) it is incorrect to maximum point value of -5. The individual’s score for the testing event is determined by adding the point value achieved for each slide, dividing by the total points for the testing event and multiplying by 100. Passing score is 90% or higher. In the previous example, if all 10 slides were correct except for the one HSIL case being called Negative resulting in a score for that slide of –5, the total score would be 85, an automatic failure. The scoring points are different for a cytotechnologist and a pathologist. If a cytotechnologist calls one case LSIL (C) instead of HSIL (D), the score remains the same, 10 points. If a pathologist calls one case LSIL instead of HSIL, the point value becomes 5 instead of 10.

Pathologists – 10 slide test
Correct Response
Examinee Response
 
UNSAT
NEGATIVE
LSIL
HSIL
UNSAT
10
0
0
0
NEGATIVE
5
10
0
0
LSIL
5
0
10
5
HSIL
0
-5
5
10

 

Cytotechnologists – 10 slide test
Correct Response
Examinee Response
 
UNSAT
NEGATIVE
LSIL
HSIL
UNSAT
10
0
5
5
NEGATIVE
5
10
5
5
LSIL
5
0
10
10
HSIL
0
-5
10
10

 

Pathologists – 20 slide test
Correct Response
Examinee Response
 
UNSAT
NEGATIVE
LSIL
HSIL
UNSAT
5
0
0
0
NEGATIVE
2.5
5
0
0
LSIL
2.5
0
5
2.5
HSIL
0
-10
2.5
5

 

Cytotechnologists – 20 slide test
Correct Response
Examinee Response
 
UNSAT
NEGATIVE
LSIL
HSIL
UNSAT
5
0
2.5
2.5
NEGATIVE
2.5
5
2.5
2.5
LSIL
2.5
0
5
5
HSIL
0
-10
5
5

 

Per CLIA regulations §493.945, for a 20-slide test there is a maximum of 5 points for a correct response. For example, if the Reference diagnosis (correct answer) is Negative for Intraepithelial Lesion or Malignancy and the participant’s answer is Repair or Trichomonas, it is considered correct to the B series for 5 points. There is a maximum of –10 points for an incorrect response. For example, if the Reference diagnosis is HSIL (category D) and the examinee response is Negative (category B) it is incorrect to maximum point value of -10. In the previous example, if all 20 slides were correct except for the one HSIL case being called Negative resulting in a score for that slide of –10, the total score would be 85, an automatic failure. The scoring grids are different for a cytotechnologist and a pathologist. If a cytotechnologist calls one case LSIL instead of HSIL, the score remains the same, 5 points. If a pathologist calls one case LSIL instead of HSIL, the point value becomes 2.5 instead of 5.

 

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