PSIV-2 Changes in free glutamine and glutamate in mare milk during early lactation

Abstract Glutamine plays an important role in neonatal health. This amino acid serves as a nitrogen and amine carrier between tissues, as a major energy source and as a precursor for nucleic acids and proteins in rapidly proliferating intestinal cells. This study aimed to evaluate changes over time in free Gln and Glu concentrations in mare milk in early lactation and their relationship with foal gut health. Thirteen Thoroughbred mare and foal pairs were studied. Milk samples were collected at 12 h, 3, 5, 7, 10, 14, and 21 d after parturition and daily milk yield was estimated at 7 and 14 d postpartum. Milk samples were centrifuged (10 min, 3500 x g, 4 °C) to remove fat, then centrifuged twice (5 min, 10,000 x g, 22 °C) to remove protein. Free Glu and Gln were analyzed in triplicate using a membrane-based glutaminase and glutamate oxidase method (YSI 2700 Analyzer, YSI Life Sciences, OH). Daily fecal scores were recorded to monitor foal diarrhea and body weights were recorded weekly. Mixed model ANOVA with repeated measures (SAS 9.4) were used to evaluate changes over time in free Gln and Glu. Relationships between variables were assessed using regression analyses and Pearson’s correlation coefficient. Free Gln and Glu changed over time (P < 0.0001). Glutamine increased from 12 h to 5 d, (0.24±0.11 mmol/L and 1.09±.11 mmol/L, respectively; P < 0.05) then decreased to 0.90±0.11 mmol/L by 21 d postpartum. In contrast, free Gln was the lowest at 12 h (0.36±0.04 mmol/L) and continued increasing through 21 d postpartum (0.80±0.04 mmol/L; P < 0.05). Bouts of diarrhea were negatively related to milk Gln (P < 0.05) and foal ADG was positively related to milk Glu (P < 0.05). These results suggest that Gln may have a role in foal gut health while Glu may influence foal growth.

Download Full-text

Impacts of rTMS on Refractory Depression and Comorbid PTSD Symptoms at a Military Treatment Facility

Military Medicine ◽

10.1093/milmed/usaa148 ◽

2020 ◽

Vol 185 (9-10) ◽

pp. e1420-e1427

Author(s):

Sean Wilkes ◽

Celia Ona ◽

Michael Yang ◽

Pingyang Liu ◽

Amber Benton ◽

...

Keyword(s):

Repeated Measures ◽

Mixed Model ◽

Repetitive Transcranial Magnetic Stimulation ◽

Active Duty ◽

Ptsd Symptoms ◽

Refractory Depression ◽

Antidepressant Medications ◽

Treatment Of Depression ◽

Changes Over Time ◽

Over Time

Abstract Introduction Repetitive transcranial magnetic stimulation (rTMS) as a treatment for depression has been studied for over two decades. Repetitive TMS was approved by the Food and Drug Administration in 2008 for the treatment of depression after at least one failed trial of an antidepressant medication of adequate dose and duration. This study evaluated whether rTMS treatments may be associated with measurable improvements in depression and post-traumatic stress disorder (PTSD) symptoms for treated military beneficiaries in Hawaii suffering from depression. It also examined the number of failed medication trials that patients underwent before rTMS treatment. Materials and Methods A retrospective chart review of 77 rTMS patients who received and completed treatment between January 1, 2010 and October 31, 2016 was performed. Under a typical treatment regimen, patients receive rTMS for 6 weeks as well as weekly psychiatric assessments, which included completion of Beck’s Depression Inventory (BDI) and PTSD Checklist (PCL). A mixed model repeated measures analysis was done assuming an autoregressive order one covariance structure to evaluate changes over time. Adjusted analyses were done to assess whether changes over time differed by age, prior diagnosis of PTSD, active duty status, and gender. Results The majority of patients were from the army (74%) and 56% were on active duty. Just over half (53%) were male. Most patients (52%) had completed trials of three or more different antidepressant medications before initiation of treatment with rTMS. The mean number of antidepressant trials was 2.7. BDI and PCL scores were significantly lower at end of treatment on average compared to the pretreatment baseline scores. Mean differences for BDI and PCL were significant with P < 0.001 15, 30, and 45 days after TMS treatment was initiated. Overall, 44% of patients experienced a reduction ≥10 points on BDI, and 38% experienced a reduction ≥10 points on PCL. Additionally, scores fell similarly regardless of whether or not patients had a comorbid diagnosis of PTSD. Conclusions Our research suggests that rTMS treatments may produce a reduction in symptoms of both depression and PTSD in patients with refractory depression and comorbid PTSD. It may be a useful alternative to antidepressants in the treatment of depression in the military population, including those with comorbid PTSD. Broader implementation of this treatment modality may prove beneficial for the purposes of military readiness, given current policies and restrictions on service members who are initiated on antidepressant medications.

Download Full-text

102 Detecting coprophagy in foals and its relationship with foal gut health

Journal of Animal Science ◽

10.1093/jas/skaa278.167 ◽

2020 ◽

Vol 98 (Supplement_4) ◽

pp. 91-92

Author(s):

Morgan B Pyles ◽

Susan Hayes ◽

Andrea Crum ◽

Miranda Kunes ◽

Elizabeth Radomski ◽

...

Keyword(s):

Milk Yield ◽

Repeated Measures ◽

Chromic Oxide ◽

Neutral Detergent Fiber ◽

Gut Health ◽

Cellulolytic Bacteria ◽

Repeated Measures Anova ◽

Milk Samples ◽

Changes Over Time

Abstract Consumption of maternal feces is commonly observed in foals; however, the role of this activity in foal health is unknown. Therefore, this study aimed to determine the occurrence of coprophagy in foals and how it relates to foal gut health. Milk samples and foal feces were collected from 12 mare-foal pairs at 12 h, 3, 5, 7, 10, 14, and 21 d after foaling. Milk yield was estimated after muzzling foals for 2 h intervals at 7 and 14 d postpartum. To detect coprophagy in foals, nine mares were fed chromic oxide (10 g/d) with their concentrate in nosebags twice daily. Mares had ad libitum access to forage. Fecal samples were collected immediately after defecation and used to enumerate cellulolytic bacteria, lactobacilli, and lactate-utilizing bacteria using culture-based techniques. Enumeration data were log10 transformed before statistical analyses. Frozen feces were used to analyze neutral detergent fiber (NDF) using a Fiber Analyzer (Ankom Technology, NY, USA), then ashed and digested to analyze chromic oxide via atomic absorption. Fecal scores were recorded daily to monitor for signs of diarrhea. Changes over time were evaluated using repeated measures ANOVA and relationships between variables were analyzed using Pearson’s correlation coefficient (SAS 9.4). Coprophagy was detected as early as 3 d after birth and detected in all foals by 7 d of age. Peak coprophagy occurred at 14 d after birth. Milk yield was negatively related to fiber and chromic oxide in foal feces (r = -0.64 and -0.70, respectively; P < 0.05). Chromic oxide in foal feces was positively related to the number of cellulolytic bacteria and NDF (r = 0.97 and 0.79, respectively; P < 0.05). Bouts of diarrhea tended to be negatively related to chromic oxide (r = -0.59; P = 0.0928). Maternal feces is likely an important source of fiber and microbial inoculum for foals, aiding in colonization of beneficial microbes.

Download Full-text

Clinical characterization of dysautonomia in long COVID-19 patients

Scientific Reports ◽

10.1038/s41598-021-93546-5 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Nicolas Barizien ◽

Morgan Le Guen ◽

Stéphanie Russel ◽

Pauline Touche ◽

Florent Huang ◽

...

Keyword(s):

Mixed Models ◽

Repeated Measures ◽

Physical Medicine ◽

Persistent Symptoms ◽

Index Changes ◽

Changes Over Time ◽

And Control ◽

Testing Group ◽

Over Time

AbstractIncreasing numbers of COVID-19 patients, continue to experience symptoms months after recovering from mild cases of COVID-19. Amongst these symptoms, several are related to neurological manifestations, including fatigue, anosmia, hypogeusia, headaches and hypoxia. However, the involvement of the autonomic nervous system, expressed by a dysautonomia, which can aggregate all these neurological symptoms has not been prominently reported. Here, we hypothesize that dysautonomia, could occur in secondary COVID-19 infection, also referred to as “long COVID” infection. 39 participants were included from December 2020 to January 2021 for assessment by the Department of physical medicine to enhance their physical capabilities: 12 participants with COVID-19 diagnosis and fatigue, 15 participants with COVID-19 diagnosis without fatigue and 12 control participants without COVID-19 diagnosis and without fatigue. Heart rate variability (HRV) during a change in position is commonly measured to diagnose autonomic dysregulation. In this cohort, to reflect HRV, parasympathetic/sympathetic balance was estimated using the NOL index, a multiparameter artificial intelligence-driven index calculated from extracted physiological signals by the PMD-200 pain monitoring system. Repeated-measures mixed-models testing group effect were performed to analyze NOL index changes over time between groups. A significant NOL index dissociation over time between long COVID-19 participants with fatigue and control participants was observed (p = 0.046). A trend towards significant NOL index dissociation over time was observed between long COVID-19 participants without fatigue and control participants (p = 0.109). No difference over time was observed between the two groups of long COVID-19 participants (p = 0.904). Long COVID-19 participants with fatigue may exhibit a dysautonomia characterized by dysregulation of the HRV, that is reflected by the NOL index measurements, compared to control participants. Dysautonomia may explain the persistent symptoms observed in long COVID-19 patients, such as fatigue and hypoxia. Trial registration: The study was approved by the Foch IRB: IRB00012437 (Approval Number: 20-12-02) on December 16, 2020.

Download Full-text

Mood and Global Symptom Changes among Psychotherapy Clients with Depressive Personality

Depression Research and Treatment ◽

10.1155/2012/208435 ◽

2012 ◽

Vol 2012 ◽

pp. 1-12

Author(s):

Rachel E. Maddux ◽

Lars-Gunnar Lundh

Keyword(s):

Repeated Measures ◽

Mixed Model ◽

Psychological Symptoms ◽

Self Report ◽

Treatment Results ◽

Repeated Measures Analysis ◽

Depressive Personality ◽

Symptom Changes ◽

Psychotherapy Clients ◽

Over Time

The present study assessed the rate of depressive personality (DP), as measured by the self-report instrument depressive personality disorder inventory (DPDI), among 159 clients entering psychotherapy at an outpatient university clinic. The presenting clinical profile was evaluated for those with and without DP, including levels of depressed mood, other psychological symptoms, and global severity of psychopathology. Clients were followed naturalistically over the course of therapy, up to 40 weeks, and reassessed on these variables again after treatment. Results indicated that 44 percent of the sample qualified for DP prior to treatment, and these individuals had a comparatively more severe and complex presenting disposition than those without DP. Mixed-model repeated-measures analysis of variance was used to examine between-groups changes on mood and global severity over time, with those with DP demonstrating larger reductions on both outcome variables, although still showing more symptoms after treatment, than those without DP. Only eleven percent of the sample continued to endorse DP following treatment. These findings suggest that in routine clinical situations, psychotherapy may benefit individuals with DP.

Download Full-text

T189. FREE THYROXIN CONCENTRATIONS MODERATE THE RESPONSE TO A COGNITIVE REMEDIATION THERAPY IN PEOPLE WITH EARLY PSYCHOSIS: PRELIMINARY FINDINGS

Schizophrenia Bulletin ◽

10.1093/schbul/sbaa029.749 ◽

2020 ◽

Vol 46 (Supplement_1) ◽

pp. S303-S304

Author(s):

Francesc Estrada ◽

Josep Maria Crosas ◽

Maribel Ahuir ◽

Sara Pérez ◽

Wanda Zabala ◽

...

Keyword(s):

Repeated Measures ◽

Cognitive Remediation ◽

Early Psychosis ◽

Cognitive Tasks ◽

First Episode ◽

Cognitive Changes ◽

Cognitive Domains ◽

Episode Psychosis ◽

Changes Over Time ◽

Over Time

Abstract Background Cognitive deficits are a common cause of functional disability in people with psychotic disorders. Cognitive remediation produces moderate improvements in cognitive performance in people with schizophrenia, although there is variability in the responses between patients. As previous longitudinal studies suggest that free thyroxin (FT4) levels influence attention cognitive tasks in patients with early psychosis, we aimed to conduct a pilot study to explore whether thyroid hormones might predict the response to cognitive remediation therapy (CRT) in patients with first-episode psychosis. Methods 27 patients (8 women; 19 men) with first-episode psychosis aged between 18 and 35 years old were randomized to receive a computerized CRT for three months (2 sessions/week) (N=14) or treatment as usual (TAU) (N=13). A full cognitive battery (CANTAB Schizophrenia) was administered at baseline and follow-up (3 months later, after the CRT/TAU period). Plasma levels of thyroid-stimulating hormone (TSH) and FT4 were measured. Data were analyzed on an intention-to-treat basis. Correlation analyses were conducted to explore the association between TSH and FT4 levels and cognitive changes over time. An ANOVA for repeated measures was used to compare longitudinal changes over time by the experimental group while adjusting for TSH and FT4 levels. Significance was defined as p<0.05. Results TSH concentrations were not associated with cognitive changes over time. FT4 concentrations were associated with cognitive worsening over time in cognitive tasks dealing with reaction time (simple median movement time [r= 0.60, p= 0.003]; simple median reaction time [r= 0.44, p= 0.039]), sustained attention (signal detection for the rapid visual processing task [r= -0.46, p= 0.028]) and verbal memory (immediate recognition [r= -0.54, p= 0.008]; delayed recognition [r= -0.48, p= 0.019]). The ANOVA for repeated measures did not show time by group effects although a time by FT4 significant effect was found for cognitive tasks dealing with these cognitive domains (p<0.05 for all). Discussion Although a direct effect of the CRT on cognitive improvement was not found, baseline FT4 concentrations appeared to predict the response to CRT in people with early psychosis. Significant associations were found for cognitive domains dealing with attention processes, which are in accordance with previous studies exploring the association between thyroid function and cognitive functioning in early psychotic patients. Our preliminary findings suggest that the determination of thyroid function status might be important for establishing which patients could show cognitive improvements over time. If these results are replicated in larger studies, the determination of thyroid status might help identify those individuals more prone for showing cognitive improvements, and allowing the implementation of a personalized medicine approach in the field of cognitive rehabilitation in psychosis.

Download Full-text

Effects of Exercise Restriction on Patients With Anomalous Aortic Origin of a Coronary Artery

World Journal for Pediatric and Congenital Heart Surgery ◽

10.1177/2150135116674444 ◽

2016 ◽

Vol 8 (1) ◽

pp. 18-24 ◽

Cited By ~ 6

Author(s):

Matthew D. Elias ◽

James Meza ◽

Brian W. McCrindle ◽

Julie A. Brothers ◽

Stephen Paridon ◽

...

Keyword(s):

Coronary Artery ◽

Exercise Capacity ◽

Repeated Measures ◽

Mixed Model ◽

Linear Mixed Model ◽

Multivariable Analysis ◽

Young Patients ◽

Significant Difference ◽

Exercise Restriction ◽

Over Time

Background: Management of young patients with anomalous aortic origin of a coronary artery (AAOCA) may involve exercise restriction. We sought to identify the association of exercise restriction with changes over time in body mass index (BMI) and exercise capacity in this cohort. Methods: We performed a retrospective review of patients with AAOCA seen at The Children’s Hospital of Philadelphia between January 1, 1998, and August 31, 2014. Linear mixed model repeated-measures analysis assessed changes in BMI and exercise capacity. Results: We included 72 patients with a median age at presentation of 12.6 years (interquartile range: 10.1-15.8) and mean follow-up of 3.6 ± 3.0 years. The majority had an anomalous right coronary artery (71%) and interarterial ± intramural coronary course (90%). Surgery was performed in 54%, more often in those with interarterial/intramural course ( P < .001) and symptoms ( P = .003). Most patients (82%) were exercise-restricted on presentation, and restricted patients were older than those who were not restricted ( P = .01). There was no significant difference between restricted and nonrestricted patients in initial BMI z scores, percentage of patients with BMI over 85th percentile (26%) or exercise capacity variables. In univariable analysis, exercise restriction over time was not associated with change in BMI z score ( P = .25) or change in exercise variables. Restriction was not associated with significant change in these variables in multivariable analysis. Conclusions: Although further investigation is warranted to determine the degree of adherence to exercise restriction, the recommendation of restriction alone is not associated with increasing BMI or decreasing exercise performance in the short-term.

Download Full-text

Abstract 52: Efficacy and Safety of Mipomersen in Patients with Familial Hypercholesterolemia and Inadequately Controlled LDL-C Levels

Arteriosclerosis Thrombosis and Vascular Biology ◽

10.1161/atvb.36.suppl_1.52 ◽

2016 ◽

Vol 36 (suppl_1) ◽

Author(s):

Christie Ballantyne ◽

Alberico L Catapano ◽

Michael Davidson ◽

Robert Mittleman ◽

Patrick M Moriarty ◽

...

Keyword(s):

Adverse Events ◽

Familial Hypercholesterolemia ◽

Repeated Measures ◽

Mixed Model ◽

Primary Objective ◽

Tolerability Profile ◽

Primary Analysis ◽

Double Blind ◽

Absolute Reduction ◽

Over Time

Aim: Mipomersen is an antisense oligonucleotide inhibitor of apolipoprotein B-100 synthesis, FDA-approved to treat homozygous familial hypercholesterolemia. The primary objective of this study was to determine whether mipomersen significantly reduced atherogenic lipid levels in patients with severe heterozygous familial hypercholesterolemia (HeFH). Methods: This was a randomized, double-blind, placebo-controlled, parallel-group study comprised of two cohorts (NCT01475825). Cohort 1 had severe HeFH (LDL-C ≥200 mg/dL + coronary heart disease, or LDL-C ≥300 mg/dL) and Cohort 2 had milder HeFH (LDL-C ≥160 and <200 mg/dL). For each cohort, patients were randomized 1:1 to 200 mg SC once weekly or 70 mg SC thrice weekly, then 2:1 to receive mipomersen or placebo for 60 weeks. The primary outcome was percent change from baseline in LDL-C in Cohort 1. The % change from baseline in LDL-C at Week 61 for mipomersen treated patients was compared to placebo using a mixed model for repeated measures (MMRM), as well as by ANCOVA on the value closest to 7 days post last treatment (LOCF). Results: Mean baseline LDL-C levels were 265 mg/dL in Cohort 1 (N=200) and 176 mg/dL in Cohort 2 (N=109). In Cohort 1, mipomersen 200 mg weekly reduced LDL-C levels by -29.7% (vs -7.9% placebo, P <.001) in the mixed model, and by -36.3% (vs -7.6% placebo, P <.001) using the LOCF. Analysis of LDL-C over time (Figure) showed a mean absolute reduction of 138 mg/dL in mipomersen patients who completed the blinded treatment period (n=32), achieving a mean level of 147 mg/dL from a mean 285 mg/dL baseline level. Tolerability to treatment and adverse events were similar between dose regimens. Adverse events were consistent with the drug’s known safety and tolerability profile. Conclusions: The primary analysis showed a significant reduction in LDL-C levels in patients with severe HeFH who received mipomersen 200 mg once weekly versus placebo. A highly relevant absolute reduction in LDL-C was achieved over time.

Download Full-text

Plasma adrenocorticotropic hormone concentration in horses decreases after freezing for 60 days

Journal of Veterinary Diagnostic Investigation ◽

10.1177/1040638719882374 ◽

2019 ◽

Vol 31 (6) ◽

pp. 856-858

Author(s):

John C. Haffner ◽

Dwana L. Neal ◽

Rhonda M. Hoffman ◽

Steven T. Grubbs

Keyword(s):

Repeated Measures ◽

Adrenocorticotropic Hormone ◽

Mixed Model ◽

Statistical Significance ◽

Hormone Concentration ◽

Plasma Acth ◽

Acth Concentration ◽

The Stability ◽

Over Time

We investigated the stability of adrenocorticotropic hormone (ACTH) in plasma after freezing for different lengths of time. The plasma ACTH concentrations of 12 horses were measured on day 0 (baseline) and over time, after stimulation with thyrotropin-releasing hormone. Samples were stored at −80°C for 3, 7, 30, 60, and 90 d, or at −20°C for 3, 7, 30, and 60 d, or between ice packs at −20°C for 3 and 7 d prior to determination of ACTH concentration. ACTH concentrations were compared to baseline (non-frozen day 0 plasma) for each storage method using a mixed model with repeated measures in which each horse served as its own control and day was the repeated effect. Statistical significance was set at p ≤ 0.05, and 0.05 < p < 0.10 was considered a trend. Plasma ACTH frozen at −20°C or at −80°C resulted in degradation of ACTH compared to baseline samples at 60 and 90 d respectively. There was no degradation of ACTH after 7 d when stored between ice packs, or before 30 d at −20°C, or before 60 d at −80°C.

Download Full-text

Repeated measures ASCA+ for analysis of longitudinal intervention studies with multivariate outcome data

10.1101/2020.12.03.20243097 ◽

2020 ◽

Author(s):

Torfinn S. Madssen ◽

Guro F. Giskeødegård ◽

Age K. Smilde ◽

Johan A. Westerhuis

Keyword(s):

Clinical Trials ◽

Repeated Measures ◽

Intervention Studies ◽

Linear Models ◽

Principal Component ◽

Component Analysis ◽

Outcome Data ◽

Biological Data ◽

Changes Over Time ◽

Over Time

AbstractLongitudinal intervention studies with repeated measurements over time are an important type of experimental design in biomedical research. Due to the advent of “omics”-sciences (genomics, transcriptomics, proteomics, metabolomics), longitudinal studies generate increasingly multivariate outcome data. Analysis of such data must take both the longitudinal intervention structure and multivariate nature of the data into account. The ASCA+-framework combines general linear models with principal component analysis, and can be used to separate and visualize the multivariate effect of different experimental factors. However, this methodology has not yet been developed for the more complex designs often found in longitudinal intervention studies, which may be unbalanced, involve randomized interventions, and have substantial missing data. Here we describe a new methodology, repeated measures ASCA+ (RM-ASCA+), and show how it can be used to model metabolic changes over time, and compare metabolic changes between groups, in both randomized and non-randomized intervention studies. Tools for both visualization and model validation are discussed. This approach can facilitate easier interpretation of data from longitudinal clinical trials with multivariate outcomes.Author summaryClinical trials are increasingly generating large amounts of complex biological data. Examples can include measuring metabolism or gene expression in tissue or blood sampled repeatedly over the course of a treatment. In such cases, one might wish to compare changes in not one, but hundreds, or thousands of variables simultaneously. In order to effectively analyze such data, both the study design and the multivariate nature of the data should be considered during data analysis. ANOVA simultaneous component analysis+ (ASCA+) is a statistical method which combines general linear models with principal component analysis, and provides a way to separate and visualize the effects of different factors on complex biological data. In this work, we describe how repeated measures linear mixed models, a class of models commonly used when analyzing changes over time and treatment effects in longitudinal studies, can be used together with ASCA+ for analyzing clinical trials in a novel method called repeated measures-ASCA+ (RM-ASCA+).

Download Full-text

Identification of Trichomonas vaginalis in Different Papanicolaou Test Preparations: Trends Over Time in the College of American Pathologists Educational Interlaboratory Comparison Program

Archives of Pathology & Laboratory Medicine ◽

10.5858/arpa.2012-0036-cp ◽

2013 ◽

Vol 137 (8) ◽

pp. 1043-1046

Author(s):

Lydia Pleotis Howell ◽

Teresa M. Darragh ◽

Rhona J. Souers ◽

Nicole Thomas ◽

Ann T. Moriarty

Keyword(s):

Proficiency Testing ◽

Repeated Measures ◽

Trichomonas Vaginalis ◽

Mixed Model ◽

Interlaboratory Comparison ◽

Papanicolaou Test ◽

Nonlinear Mixed Model ◽

Before And After ◽

Performance Results ◽

Over Time

Context.—The College of American Pathologists' Interlaboratory Comparison Program in Gynecologic Cytology has seen an increase in enrollment in liquid-based Papanicolaou test challenges with a decrease for conventional Papanicolaou tests. Trichomonas vaginalis can be difficult to identify in all preparation types. Objectives.—To evaluate 20 years of participant results from the College of American Pathologists Interlaboratory Comparison Program in Gynecologic Cytology for Trichomonas to ascertain whether performance has changed because of the introduction of liquid-based Papanicolaou and proficiency testing. Design.—Concordance rates for the target diagnosis of Trichomonas vaginalis were evaluated for 167 956 participant responses (1990–2010). A nonlinear mixed model was fit with participant type, preparation type, and a 2-level program year (1990–2005 and 2006–2010) reflecting before and after proficiency testing began. A repeated-measures component allowed modeling of the slide-specific performance to ensure that the overall results were not based on the performance of a few slides. Results.—Cytotechnologists had higher concordance with the target diagnosis than did pathologists (89.8% [72 992 of 81 319] versus 83.4% [72 271 of 86 637], P < .001) and better performance for each preparation type (P = .003). Concordance initially dropped after the introduction of proficiency testing (P < .001) for conventional and liquid-based (SurePath) preparations by both participant types, followed by quick, parallel improvement. Conclusions.—Performance is high in the detection of Trichomonas vaginalis in the College of American Pathologists Interlaboratory Comparison Program in Gynecologic Cytology. Liquid-based Papanicolaou and proficiency testing minimally affected participant performance. Cytotechnologists performed better over time and across preparation types than did pathologists, although pathologists showed performance results parallel to that of the cytotechnologists. Awareness of the performance differences by pathologists and cytotechnologists, as well as their difference in proficiency among liquid-based techniques, may help ensure accurate results in clinical practice.

Download Full-text