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HERDIN Record #: R07-CIM-18031213044040 Submitted: 12 March 2018 Modified: 19 July 2018

A comparative study between the graded results of sputum AFB smears prepared from the standardized approach and non-standardized approach in smear preparation.

Joni B. Abdon,
Aldred Adams M. Angulo,
Erwin Cempron,
Ives Brylle  Villas,
Faith Caren Castro,
Anjorie Pearl Co,
Kathleen Joyce C. Del Carmen,
Monica Janine  C. Lee,
Francine B. Lucero,
Maricris  P. Mahinay,
Venees Sherry  P. Narvaez,
Jan Angeli T. Ong,
Danica Julia P. Oliveros ,
Karen L. Opay,
Eliel Panglinawan,
Kathleen B. Rabe,
Maria Rheena Flor  C. Zamora

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Sputum smear microscopy is widely used in the diagnosis of pulmonary tuberculosis in the Philippines. Different laboratories or microscopists may differ in their approach to the procedure such that the DOH-NTP established standard guidelines to encourage uniformity and reproducibility of the results. This study aims to determine whether or non-standard smear preparation, that is not compliant to the standard guidelines set by DOH-NTP differ from that using the standard in terms of the degree of agreement of their graded results. Cohen's kappa statistics was used to determine such parameter which yielded a value that implies only fair agreement (κ = 0.359) among the two approaches. The two smearing methods were then subjected to quality control (QC) which affirmed that the standard set-up did comply with the standard guidelines in terms of quality while the non-standard complied less. However, it appears that the non-standard set-up has much greater agreement with the QC's graded results, (κ= 0.366) compared to the standard set-up (κ= 0.198), albeit still considered a fair, and poor agreement respectively. With this, we recommend further studies considering this apparent paradox that may be due to reader error. Nonetheless, given that there is considerate disagreement between the two approaches, this study reinforces the idea that sputum smear microscopy must adhere to standard guidelines to ensure the quality of prepared slides.  

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