Biomedical Engineering Reference
In-Depth Information
During another demm, another cytologist and cytodiagnostician are
assessing indicated cervical cytology. The cytologist takes a cytology
request form and the two adjacent slides. The cytodiagnostician says
that apparently gynaecologists nowadays sometimes take two slides for
the indicated cervical cytology samples. The cytologist assesses the dots
in silence, and then says: 'this is zero point fi ve', and laughs. He then
takes the second slide of the two, which he also assesses in silence. After
a while he says: 'this one is one point twenty-fi ve'.
In the two cases above from different joint diagnostic sessions at Cyto lab
(called the 'demm' in the lab vernacular), the cytologists seemed to actually
perceive nuances, i.e. further classifi cations, within the predetermined
classifi cations. This was also the case for the cytodiagnosticians. Whereas the
cytologists and the cytodiagnosticians generally considered the predetermined
classifi cations to be adequate for use in daily practice, they said that at times
the cells did not match, or fell in between, the classifi cations, as exemplifi ed
by Filippa at Cyto lab:
You can go across the boundaries too, if you think that (…) you call it
CIN I-II for example, or CIN II-III. You can call it that, or that's what
they do also, and then you mean that most of it, is maybe a CIN I, but
there are also cells, cell changes, that are CIN II. It is something like
'What should I do?' If you really don't want to fi nalise this as a CIN II,
but you see that there are cells that
can
be CIN II, then you do this, CIN
I-II. That works. So, no, I think that on the whole it is good with the
classes that exist.
Others said that occasionally cells were completely impossible to classify.
Not all cells could be matched with a particular classifi cation, as the variation
of cells exceeded the classifi cations:
… sometimes it just doesn't work, to put it simply, there aren't codes so
that it agrees.
(Karin, Cyto lab)
Another cytodiagnostician raised this point as well:
ELSA:
Sometimes it just doesn't work to say 'what is this here?', I just see that
the cells are changed, that there is something that isn't normal.
ANETTE:
It doesn't always work to fi t it into the classifi cation system?
ELSA:
No, no, no. You see that the cells are changed by bacteria, or candida
or trichomonas, or (...) but you
know
that picture, so to speak. But then
there is yes, that sometimes the cells are badly preserved, or unclear in
some other way, and then they often come in those groups. Ehh (…)
unclear, new sample, for the sake of safety, so to speak.
