Smear tests were not on trial but should have been

EDITOR—In February three women were declared victims of medical negligence because their smear abnormalities were missed at the Kent and Canterbury Hospital.1

This raises some serious questions. Did the judge understand how reliably the smear test performs under day to day conditions—that for every 90 000 slides reviewed several hundred will be reallocated a new category? Did he know that borderline cases and inadequate samples are not included in quality assurance tests in the United Kingdom because they cannot be agreed on? The rate of interobserver agreement …