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Multiple Slide Blinded Rescreening

Multiple slide blind rescreening (MSBR) is the only method that provides an unbiased and objective assessment of how a specific Pap slide(s) would be interpreted in a simulated, typical screening environment.

Whereas retrospective analysis of litigation slides is prone to the effects of outcome and context bias, MSBR is an objective, unbiased and impartial method that is fair to both the patient and the health care provider. It remains as the only unbiased basis for asserting that the specific reading of a slide (or slides) is “below the standard of practice”. It indicates what could reasonably be expected of a well-trained competent and prudent practitioner under similar circumstances.

Blind rescreening results indicate below standard performance only when a slide (or slides) in question is interpreted regularly and reliably as clinically significantly more abnormal than the original interpretation.

Multiple slide blind rescreening has been endorsed by all of the national cytopathology-associated organizations (American Society of Cytopathology, College of American Pathologists, and American Society for Cytotechnology) and by the overwhelming majority of state and local pathology and cytology societies.

Litigation case studies from our files

• Case 69

• Case 83

• Case 99

Articles on Blinded Review

Please refer to the following references for more information:

• Austin RM. Results of blinded rescreening of Papanicolaou smears versus biased retrospective review. Archives of Pathology & Laboratory Medicine. 121:311-314.

• Renshaw, Andrew A.; Young, Mary L.; Holladay, E. Blair. Blinded review of papanicolaou smears in the context of litigation. Cancer Cytopathology 2004; 102: 136-141.

• Frable, William J. Blinded review of papanicolaou smears. Cancer Cytopathology 2004; 102: 133-135.

• Gill, Gary W. Blinded review of papanicolaou smears. Cancer Cytopathology 2005; 105: 53-55.

• Renshaw, Andrew A.; Holladay, E. Blair; Geils, Karen B. Results of multiple-slide, blinded review of papanicolaou slides in the context of litigation. Cancer Cytopathology 2005; 105: 263-269.

• Volk, Emily E.; Austin, R. Marshall. Before litigation, blinded rescreening a must. CAP updates guides for review of pap tests in litigation or potential litigation. CAP Today May 2002.

• Holladay, E. Blair; Gill, Gary; Clark Jennifer J. Recuse yourself-you're biased! Diagnostic Cytopathology 2003; 29: 303-304.

• Guidelines for Review Of GYN Cytology Samples in the Context of Litigation - Endorsed by the CAP, ASC, and the ASCT.