Effect of absence clinical history in diagnostic accuracy of thyroid fine needle aspiration cytology

• Published in: Malaysian Journal of Medicine and Health Sciences
• Main Author: Roslan N.N.; Abu M.N.; Abd Malek N.N.; Roslan N.A.; Alihad N.A.; Mohamad S.N.; Md. Isa K.A.
• Format: Article
• Language: English
• Published: Universiti Putra Malaysia Press 2021
• Online Access: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85108978159&partnerID=40&md5=a6ab6478012fbb7193655dfe91ef34d9

Introduction: Slides without clinical history can influence diagnostic interpretation accuracy, contributing to misdiagnosis and impair consistency. The goal is to evaluate the new screeners’ performance through blinded cytology screening of thyroid FNAC cases by demonstrating reliability and diagnostic accuracy between inter-and intra-observers. This study conducted a correlational research design at Cytology Laboratory, Faculty of Health Sciences, Universiti Teknologi MARA (UiTM) Selangor, Malaysia. Methods: Five new screeners were chosen to blindly screen slides without unprovided clinical history to measure competency. Diagnoses were obtained using a light microscope from two screening sessions, with 40 cases, respectively. The inter-and intra-observer reliability testing was measured using the kappa value of Fleiss’ and Cohen’s kappa value, respectively, while the diagnostic accuracy without a clinical history was determined by the receiver operating characteristic (ROC) curve. Results: The inter-reliability kappa value (multiple new screeners) unveiled as ‘Fair’ agreement (κ) = 0.598, while intra-reliability (single new screener) showed ‘Almost Perfect’ agreement with (κ) = 0.856. The overall diagnostic accuracy was an average of 83.50 %, and the area under the curve (AUC) of ROC was 0.837 (83.7%). Operating parameters show an average value of 87.38% for sensitivity, 79.98% for specificity, 81.26% for positive predictive value (PPV), 86.62% for negative predictive value (NPV), and 23.73 for likelihood ratio (LR). Conclusion: Most new screeners have ample knowledge and skills in cytological screening. This blinded screening could be a practice to access a new screener’s true ability in the future. © 2021 UPM Press. All rights reserved.