Dr. Peter McKenna:

That is a very interesting question. The answer is that there is no internationally accepted best practice as to how one conducts one of these reviews. As I said earlier, it depends entirely on the use of the result of the review. If it is being used for purely educational and quality improvement purposes, one can set the bar extremely high. If one is trying to mimic the situation in which the normal screener works, the bar clearly comes down a bit. There are time restraints. The person may only have ten or 15 minutes to look at it. There is no internationally accepted best way of doing this. We have explored how they do it in some parts of the world where they would mix one abnormal smear in with 50 normal ones and see how a panel of screeners would interpret that. That is why, as I said earlier, we are going to some lengths to come up with a system that is robust and fair to the patient and the system.