PubMed · 10730458
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J de Andrés Pizarro. 2000. [Qualitative study analysis].. https://doi.org/10.1016/s0212-6567(00)78463-0
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BACKGROUND: Multiple blinded rescreenings of Papanicolaou (Pap) smears for litigation purposes is based on the assumption that a subset of Pap smears can be reproducibly identified. The size of this subset is not known. METHODS: To estimate the size of the subset of Pap smears that can be reproducibly identified, a model was constructed based on the results of repeated blinded screenings in the AutoPap Primary Screening System Trial. Additional analysis came from data in the literature. RESULTS: Routine and AutoPap-assisted screening both have a detection rate for all detected abnormal cases of < 50%. Models with only two subsets or types of slides each with a different detection rate correlated well with the available data. Data from multiple rapid reviews strongly supported the existence of additional definable subsets. Although the percentage of cases with an expected detection rate of 100% in a three-subset model might have been as high as 30% of the abnormal cases detected in a single review, all estimates that included a second subset of slides with at least a 50% detection rate limited the percentage of slides in the 100% sensitive subset of slides to < 2% of all abnormal slides and < 6% of all abnormal slides detected by a single screening. CONCLUSIONS: Repeated screenings of Pap smears allowed more accurate models of the sensitivity of Pap-smear screening and the overall incidence of abnormal cases. The data strongly supported the existence of multiple subsets of Pap smears, which can be defined by repeated blinded rescreenings. The percentage of slides that can be reproducibly identified was small.
In a systematic review (SR) the information from the original studies is searched, selected, extracted, appraised and summarised in a transparent, valid and reproducible manner. SRs are therefore an efficient and reliable source of information for the clinician, health policy maker and researcher. SRs can be identified in various sources. The search strategy is determined by the desired comprehensiveness, the availability of various sources and the need for additional comments on the SR by a referee. In Medline a sensitive filter is available for searching SRs. An SR should be based on a carefully formulated clinical question that can be answered on the basis of data from the original studies. SRs should be thoroughly assessed as they can differ substantially in terms of quality. In such an appraisal the following aspects should be considered: question, search strategy, selection of studies, quality assessment, data extraction and data presentation, (statistical) summary of the data, statistical and clinical heterogeneity, results and conclusion. Various assessment lists are available. Differences in conclusions between SRs on the same subject can be analysed in a systematic manner and can often be resolved.
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