Sigmund,
the key to the advantages of the autopap are that NPTH already has an auto dotter ready to be installed in their machines once the FDA finally gets around to taking their FDA panels primary screening recommendation.
The autodotter wll effectively remove screening errors, ie, the errors that occur when cells are going by too fast for a tech to notice abnormality. Also, a dotted area will cause the tech to look more closely at the cells and the tech will more readily refer a slide to a supervisor or acknowledged peer expert for review.
Techs are like long distance truck drivers with scenery going by them at 80mph, 50 mph, 15 mph, etc, or stop. Stop is the safe speed, at stop you study visual characteristics carefully, like stopping at interesting artwork.
Some techs are unsafe at any speed, they do not have the visual acuity or training that would allow them to become an excellent tech.
I am reminded of a Persian Cytotech, who really wanted to be a MD and became a Cytotech by default, who missed a roaring keratinizing severe dysplasia all over the slide, (this atypia is bright orange with ink black nuclei indicating abnormally high dna levels/percancer changes). When I gave it back to him he told me that these were inflammatory changes and that all women are filthy.
He would not change his opinion, even when pressured. This type of misjudgement is rampant among cytotechnologists but now that lawsuits are looming over our heads the misjudgement often results in overcalling, false aypias/positive. Patients are being overtreated
because techs and pathologists are grossly overcalling. I have given up being upset over unjustified, unproductived biopsies. The pendulum keeps swinging but accuracy is still lacking.
Not only will the autopap with autodotters prevent a mediocre/bad tech from missing true atypia, it will also stop some of the overcalling.
I am predicting that when the autopap signs out the easy slides, mediocre techs will either have to sharpen skills or leave the profession. Their work will be consistantly more challenging.
Hopefully, the autopap will also remove some of the epidemic paranoia in my profession. We techs will no longer have to worry about tiny cancer cells being totally missed by human eyes.
Rather wordy response, I know. One of their reps told me about 2 months ago that they are on the outs with Cytech, this is good news to me. (They are fitting for their corporate lives.) NPTH is going to team up with a company that has developed a method to produce thin layer, (no thick artifact to obscure cells), pap smears that cover an entire 50 mm slide. A great improvement over the approx. 50% smear size provided by cytech. More cells, better diagnosis.
This technology will become the standard of care soon. The onsite application is always preferable to packaging and sending. There are so many reasons why this technology is better the papnet, I can not list them all here. Cytology and histology are the last laboratory frontiers where apathetic, tired, burned out and poorly trained people
are allowed to sign out cases without mechanical QA assistance. We are way overdue for this technology. I welcome it with open arms and so do all the other old timers that have pulled way to many missed cases out of the files.
We laugh about flying without a net when we screen. Autopap is the net. By the way, $4-$5. a pap is small expense to insure the Cervical cancer is caught in time, it is a silent killer caused by a virus that can be contracted with the first unprotected sexual encounter. I see this cancer in 20 year olds. Many anxious women lined up to spend $50.00 for papnet. Insurance carriers are already reimbursing in California for the QC Autopap procedure the FDA has already approved. We will be bringing in the Autopap as soon as our main insurance carrier approves it and I know others that are just waiting for the carriers to approve. |
