The Effect on Absence of Clinical History and Demographic Data in Diagnostic Accuracy of Genitourinary Cytopathological Cases Among Undergraduate Medical Laboratory Technology (MLT) Students

Abstract

Introduction: Genitourinary cytology is a cytomorphological study of benign and malignant urinary cells under microscopic observation. Slide observers were presented with glass slides devoid of demographic information and clinical history in this research. The aims are to evaluate inter- and intra-observer reliability and diagnostic accuracy in genitourinary cytopathology patients without relying on the clinical history and demographic information. Methods: A correlational investigation was conducted at the cytology laboratory, Centre for Medical Laboratory Technology (MLT) Studies, Faculty of Health Sciences, Universiti Teknologi MARA (UiTM), Puncak Alam Selangor. Five undergraduate students were recruited as slide observers to screen 26 genitourinary cases using a light microscope. The Fleiss’ and Cohen’s kappa values were used to assess inter- and intra-observer reliability, respectively, and the receiver operating characteristic (ROC) curve was employed to assess diagnostic accuracy in the absence of clinical history. All collected data were analysed using SPSS software. Results: Inter- and intra-observer reliability were interpreted as ‘fair agreement’ with an average sensitivity of 100%, specificity of 13.16%, Positive Predictive Value (PPV) of 70.4 percent, Negative Predictive Value (NPV) of 100%, and a Likelihood Ratio (LR) of 2.454. The diagnosis accuracy of these genitourinary cases is 70.5%. Conclusion: Undergraduate students in MLT, UiTM are sufficiently competent to identify and diagnose genitourinary cytology slides based on cell’s morphological characteristics without the assistance of demographic data or patient history.