Validity and Reliability of Pap Smear Healthcare providers should be familiar with the various factors that can affect the specimen adequacy, validity, and reliability of the Pap Smear. For example, the specimen may
4 be reported as unreliable if inflammation is present in or around the cervix. Inflammation causes difficulty in analyzing and interpreting the Pap smear effectively (Verma et al., 2014 ) . Specimens will also be deemed inadequate if they lack endocervical cells. The spot in the cervix where the cells transition and become endocervical is sometimes too far back for the sampling instrument to reach and access. Difficulty visualizing the transition zone adequately is another common cause of sample inadequacy due to the absence of endocervical cells (Poonam, 2019) . There are a handful of studies that indicate that the use of gel lubricant during Pap smears may obscure the cellular components and cause inaccurate analysis. However, other studies addressing this topic have demonstrated contradictory results. Due to the conflicting results of existing studies, current guidelines recommend lubrication with water. Further studies will be necessary to make a conclusive determination (Ball et al., 2015). Based on multiple studies, it is apparent that the diagnostic accuracy of the Pap smear is quite high; however, it is not 100% accurate. A recent study demonstrated the Pap smear to be 81.5% accurate in diagnosing pre-malignant and malignant disease (Poonam, 2019). Another similar study showed a diagnostic accuracy of 92% with the Pap smear (Verma et al., 2014) . The same study demonstrated the specificity of the Pap smear to be 88.67%, and the sensitivity to be 78.57%. Specificity refers to the ability of the testing and analysis to avoid producing false-positive results. The sensitivity of the test refers to the reliability of the test in identifying every existing abnormality in the samples (Poonam, 2019).
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- Summer '15
- Squamous cell carcinoma, Diagnostic Tests, Gynecological cancer, Bethesda System