Terminology of false negative and false positive pap smears:“They're just worms”

✍ Scribed by Sonya Naryshkin; Diane Davey

• Publisher: John Wiley and Sons
• Year: 1996
• Tongue: English
• Weight: 230 KB
• Volume: 14
• Category: Article
• ISSN: 8755-1039
• DOI: 10.1002/(sici)1097-0339(199602)14:1<1::aid-dc1>3.0.co;2-o

✦ Synopsis

The movie "Roxanne" starring Steve Martin illustrated the profound effect words can have on the course of events and upon people's perceptions of facts. As Steve Martin hides in the bushes, coaching an inept suitor, the trainee misinterprets Steve Martin's prompt "They're just words," and calls "They're just worms" to the puzzled maiden.

Lately there seem to be quite a few "worms" concerning the terminology of false negative and false positive Pap smears. When these appear in the medical literature, they cause misperceptions. * When they appear in the lay press as quotations from prominent cytopathologists, the damage is multiplied. And condemnations of cytology laboratories based upon inappropriate comparisons of incomparable statistics are a public health disservice! An example is as follows: A recent article concerning the Milwaukee laboratory charged with reckless homicide related to misread Pap smears quotes one prominent cytopathologist as saying that 4.7% false negatives is "pretty high." "In random rescreening in our lab, our criteria is 1 % for false negatives." The article later quotes another expert cytopathologist who "uses 5% as an 'absolute irreducible' false negative rate even though other experts say the figure could be as high as 15-20%." How can the public make any sense of the issue when the cytopathology profession itself is so riddled with "worms"? So, let's all be perfectly clear when discussing "error rates" of Pap smears. Below are commonly used terms and their definitions. Included are examples of how the terms have been misused and misunderstood.