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Review: the extended tip spatula is more effective than the Ayre's spatula for detecting karyosis in cervical smears

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 QUESTION: In women having cervical smears, what devices are most effective for obtaining adequate smears and detecting disease?

Data sources

Studies were identified by searching Medline (to July 1997), handsearching 16 journals, and scanning the references of relevant articles.

Study selection

Studies were selected if they were randomised controlled trials (RCTs) that reported rates of endocervical cells collected, detection of dyskaryosis, or adequate smears.

Data extraction

Data were extracted on methods of randomisation, participant characteristics, source of recruitment, proportions of smears with endocervical cells and dyskaryotic cells, and proportion of adequate smears.

Main results

34 RCTs met the selection criteria. The method of randomisation was described in 27 studies; 16 studies reported inadequate methods of randomisation. The extended tip spatula led …

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  • Sources of funding: Well-Being Charity and Royal College of Obstetricians and Gynaecologists.

  • For correspondence: Dr P Martin-Hirsch, Department of Obstetrics and Gynaecology, St. Mary's Hospital, Manchester M13 OJH, UK. Fax +44 (0)161 276 6107.

  • * p Values calculated from data in article.