Dave Nuttall Network Manager and Scientific Advisor PHW Staff Conference – Oct 15 th , 2009. CAESAR Computer Assisted Evaluation – Screening And Reporting The Cervical Screening Wales Focal Point Project. Acknowledgements.
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Network Manager and Scientific Advisor
PHW Staff Conference – Oct 15th, 2009CAESARComputer Assisted Evaluation – Screening And ReportingThe Cervical Screening Wales Focal Point Project
University of Sheffield. Jan 2006
Diagnostic Services Programme: The Future Delivery of Pathology Services in Wales, 2007
Add barcode labelled SurePath™ slides to a slide tray (8 slides per tray)
Load slide trays into input hopper of BD FocalPoint™ slide profiler (max 36 slide trays at any one time = 288 slides)
Racks can be loaded and unloaded at any time
Minimum 120 slides per run
There is no maximum number of slides per run
GS Review Station leads to inconsistencies which will affect the calculation of individual and laboratory sensitivities
DatabaseBD FocalPoint™ GS Imaging Workflow:
GS Review Station
Data transfer via
or VPN connection
GS Review Station
CERVICAL SCREENING WALES leads to inconsistencies which will affect the calculation of individual and laboratory sensitivities FOCAL POINT PROJECT - PROCESS MAP
SLIDES ARE READ
ON FOCAL POINT
OPINION OF 10 F.O.V.
HARD DRIVE +
Process Review data
RESULTS TO CSW
- LGS/multi-header microscope sessions involving representatives from Labs / CSW/ Med Sol
> Ranking’ facility against diagnostically confirmed sample abnormality profiles 15% QC
Sorting & Ranking (Illustration)
The FocalPoint™ SORTS and RANKS slides between the values of 0 and 1 : based on the likelihood of abnormality being present. 0 is negative : 1 is abnormal
< 25% Archive
> 75% Review
Note: this Ranking’ facility against diagnostically confirmed sample abnormality profiles
Contains PR as
Well as NFR
samplesFP Quintile Distribution
Focal Point Scant Cellularity Category (FPSC) Ranking’ facility against diagnostically confirmed sample abnormality profiles
Compared to a Final Report of Inadequate
Assessment of the Focal Point Slide Profiler NFR (No Further Review) category as a reliable indicator of negative samples“NFR” – DOES IT WORK?
Samples Assigned for NFR Review) category as a reliable indicator of negative samples
Compared to Final Result
The overall False Negative Rate was 3.5%
Statistically – Significant difference from 1.
NFR is therefore at least as effective as Manual Rapid Pre-screen as a QA tool for primary screening of cervical samples.
Sensitivity (134-12)/134 = 91%
Sensitivity (788-202)/788 = 74.4%
* See references and CSW data
Is an indicator of the number of failed slide scans in a given FP run
It reflects technical quality, bar code integrity etc.
Note the low value for YGC, which has been mainly attributed to tape coverslipping
Note the remarkable similarity of the mean screening times.
Note also that NFR category accounts for 22% of samples
- no FOVs, therefore potential productivity increase.
Recommendations Focal Point Slide Profiler
Analysis of the findings of this study are not yet complete.
At this stage initial results indicate that the technology is suitable for routine use, with potential quality and service management benefits to the cervical screening programme in Wales