Using Poisson Regression to Compare Rates of Unsatisfactory Pap Smears Among Gynecologists and to Evaluate a Performance Improvement Plan
Bibliographic record
Abstract
OBJECTIVE: To evaluate impact of a performance improvement (PI) plan implemented after initial analysis, comparing 7 gynecologists working in 2 clinics. STUDY DESIGN: From January to October 2005, unsatisfactory rates for gynecologists and clinics were calculated. A PI plan was instituted at the end of the first quarter of 2006. Unsatisfactory rates for each quarter of 2006 and the first quarter of 2007 were calculated. Poisson regression analyzed results. A total of 100 ThinPrep Pap smears initially deemed unsatisfactory underwent reprocessing and revaluation. RESULTS: The study's first part evaluated 2890 smears. Clinic unsatisfactory rates, 2.7% and 2.6%, were similar (p > 0.05). Gynecologists' unsatisfactory rates were 4.8-0.6%; differences between each of the highest 2 and lowest rates were significant (p < 0.05). The study's second part evaluated 13,453 smears. Unsatisfactory rates by quarter were 1.76%, 0.67%, 0.38%, 0.70% and 0.76%; the first quarter's rate was higher than in other quarters. For the study's third part, 13 of 100 reprocessed smears remained unsatisfactory. CONCLUSION: Gynecologists' unsatisfactory rates can differ. Analyzing differences can result in quality improvement. Reprocessing ThinPrep smears is an important means of reducing unsatisfactory rates but should not be a substitute for attention to quality in sampling.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.060 | 0.106 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".