Rapid Review Method Research Articles

The efficacy of scaling root planing to inflammation biomarker of periodontitis patients with atherosclerosis

ABSTRACT Periodontitis is a disease of surrounding dental tissue with a prevalence of 74.1% inIndonesia. Many studies show periodontitis plays a role in the progression of atherosclerosis. Therelationship between these two conditions shows that scaling root planing intervention can reduce therisk of atherosclerosis. This study aimed to know the efficacy of scaling root planing on changes ininflammatory biomarkers in periodontitis patients with atherosclerosis. This systematic literature reviewwas conducted using the Rapid Review method that refers to the Preferred Reporting Items forSystematic Review and Meta-Analysis (PRISMA) guidelines. Electronic searches were carried out from 4electronic databases, including the National Library of Medicine (Medline / PubMed), The CochraneLibrary, EbscoHOST, and SAGE Journal. Inclusion and exclusion criteria selected 6 RCT articles to beanalyzed qualitatively. Within 2 to 6 months, research in 6 RCT articles showed the results insignificantly reducing CRP levels as the main biomarkers of atherosclerosis after scaling root planingintervention. Other biomarkers that were also assessed are cytokines levels, lipid profile components,WBC, and fibrinogen. Overall results showed a positive effect of scaling root planing intervention inreducing the inflammatory biomarker levels of atherosclerosis in periodontitis patients withatherosclerosis. The treatment of scaling root planing is considered effective in reducing theinflammatory biomarker levels of atherosclerosis in periodontitis patients with atherosclerosis to reducethe level of risk. KEYWORDS: scaling root planing, inflammatory biomarker, atherosclerosis

One Health Approach for the Control of Zoonotic Diseases

Zoonoses are infectious diseases that can be transmitted from animals to humans and/or from humans to animals. Approximately 75% of new emerging and re-emerging disease pathogens are zoonotic: 60% spread from domestic and wild animals, and 80% are of concern regarding bioterrorism. For the past 20 years, the world has faced several zoonotic disease outbreaks. Some zoonoses can cause recurring outbreaks, such as Ebola virus disease, salmonellosis, Marburg disease, rabies and anthrax. Still others, such as the novel coronavirus causing COVID-19, have the potential to cause worldwide pandemics. The high risk of emerging and reemerging disease spillover and burden has been increased by extensive interactions among animals, humans and ecosystems. Hence, this complex health threat strongly requires a multi-sectoral collaboration known as the One Health approach. This article discusses recent scientific policies, initiatives, best practices, systems and challenges in One Health. The critical rapid review method was used, with a particular emphasis on available and recent global information. Literature found in Google Scholar and PubMed, and data publicly available on the websites of major global, regional and national organizations were included. The aim of this article is to provide compiled information and increase awareness.

Issues and Problems in Educational Surveillance and Proctoring Technologies

Introduction. The increase of online course offerings due to COVID 19 has substantially increased eproctoring technology used to streamline classroom management and assessment. Faculty and students are increasingly concerned about the requirements of these systems. This presentation will: Explore the experiences of eproctoring internalized by college. Categorize this population's experiences and concerns in the context of eproctoring and surveillance. To do so, the following research questions are considered: How is eproctoring described in scholarly literature, social media, and student print media? What components of eproctoring surveillance are viewed as detrimental to student learning using these sources, and how do the impacted individuals describe these components? Research Methods. The presenters rapid review method is intended to provide timely decision-making information compared with standard systematic reviews. This method demonstrates the urgency and impact of eproctoring technologies on students. Institutions may use this information to make informed and holistic decisions on the specialized software they acquire and implement. For this study, the unit of analysis refers to unique student responses to eproctoring. The authors include (a) Peer-reviewed scholarly literature, (b) traditional print, (c) student print media defined as newspapers and magazines, (b) social media. Preliminary data (N = 20) describes e-proctoring surveillance technology as anxiety-provoking, intrusive, discriminatory, and adversarial. Stakeholders actively push back against e proctoring requirements and demand transparency, aligning with prior research on student privacy (Ifenthaler & Schumacher, 2016). Implications for Higher Education Policy or Practice. This study's results inform policymaking around assessment practices, standardizing expectations, and creating eproctoring standards and policies that center students' rights, personhood, and privacy that outweigh the need for convenient assessment.

Maximizing Participant Engagement, Participation, and Retention in Cohort Studies Using Digital Methods: Rapid Review to Inform the Next Generation of Very Large Birth Cohorts.

BackgroundMany current research needs can only be addressed using very large cohorts. In such studies, traditional one-on-one phone, face-to-face, or paper-based engagement may not be feasible. The only realistic mechanism for maintaining engagement and participation at this scale is via digital methods. Given the substantial investment being made into very large birth cohort studies, evidence for optimal methods of participant engagement, participation, and retention over sustained periods without in-person contact from researchers is paramount.ObjectiveThis study aims to provide an overview of systematic reviews and meta-analyses evaluating alternative strategies for maximizing participant engagement and retention rates in large-scale studies using digital methods.MethodsWe used a rapid review method by searching PubMed and Ovid MEDLINE databases from January 2012 to December 2019. Studies evaluating at least 1 e-engagement, participation, or retention strategy were eligible. Articles were screened for relevance based on preset inclusion and exclusion criteria. The methodological quality of the included reviews was assessed using the AMSTAR-2 (Assessing the Methodological Quality of Systematic Reviews 2) measurement tool, and a narrative synthesis of the data was conducted.ResultsThe literature search yielded 19 eligible reviews. Overall, 63% (n=12) of these reviews reported on the effectiveness of e-engagement or participation promotion strategies. These evaluations were generally not conducted within very large observational digital cohorts. Most of the contributing reviews included multipurpose cohort studies (with both observational and interventional elements) conducted in clinical and research settings. Email or SMS text message reminders, SMS text messages or voice notifications, and incentives were the most commonly used design features to engage and retain participants. For parental outcomes, engagement-facilitation interventions influenced uptake and behavior change, including video feedback, goal setting, and intensive human facilitation and support. Participant-stated preferences for content included new knowledge, reminders, solutions, and suggestions about health issues presented in a clear, short, and personalized way. Perinatal and postpartum women valued self-monitoring and personalized feedback. Digital reminders and multiple SMS text messages were specific strategies that were found to increase adherence to medication and clinic attendance, respectively.ConclusionsThis review adds to the growing literature evaluating methods to optimize engagement and participation that may apply to large-scale studies using digital methods; it is promising that most e-engagement and participation promotion strategies appear to be effective. However, these reviews canvassed relatively few strategies, suggesting that few alternative strategies have been experimentally evaluated. The reviews also revealed a dearth of experimental evidence generated within very large observational digital cohort studies, which may reflect the small number of such studies worldwide. Thus, very large studies may need to proactively build in experimental opportunities to test engagement and retention approaches to enhance the success of their own and other large digital contact studies.

350 Enhanced maternal mortality surveillance identifies higher mortality ratios and greater racial/ethnic disparity than death certificates

To describe California’s Pregnancy Mortality Surveillance System (CA-PMSS), a rapid case review method for tracking pregnancy-related deaths statewide. To compare death counts and maternal mortality measures from CA-PMSS with those based on two conventional case ascertainment methods: death certificate data only and linked vital records. CA-PMSS identified deaths that occurred while pregnant (including early pregnancy) or within 1 year of pregnancy via linkage of vital records and hospitalization data. Coroner reports and medical records were obtained to confirm pregnancy status, verify timing to death, and supplement case information. An expert committee determined the cause of death and relationship to pregnancy based on review of these records. For deaths identified by death certificate data, pregnancy-relatedness was determined using obstetric codes. CA-PMSS death counts and mortality ratios were compared to those generated by (1) death certificate data alone and (2) linked vital records data (i.e., death, birth, and fetal death files) to assess misclassification of obstetric deaths. Data were disaggregated by race/ethnicity to examine differences in disparities by case ascertainment method. In 2009-2016, 254 maternal deaths were identified by death certificate data; 341 deaths by linked vital records data; and CA-PMSS identified 446 pregnancy-related deaths within 42 days postpartum. As a result, mortality ratios generated by CA-PMSS were 76% higher than those based on death certificate data alone and 31% higher than those using linked vital records. The 2014-2016 mortality ratio generated by CA-PMSS revealed greater racial/ethnic disparities than the one based on death certificate data. CA-PMSS, a record review method for maternal mortality surveillance, provides a more complete and accurate accounting of pregnancy-related deaths than death certificate data alone or linked vital records. Accurate pregnancy-related mortality data are critical for public health surveillance.

ADVANCE CARE PLANNING AMONG LGBT PEOPLE: AN INTEGRATIVE REVIEW AND ANALYSIS

Lesbian, gay, bisexual, and transgender people (LGBT) with advanced illness need culturally competent advanced care planning (ACP) services but often encounter structural and communication barriers. The aim of this study was to examine the ACP behaviors of LGBT people. An integrative rapid review method was used to search electronic databases for peer reviewed and non-peer reviewed publications between 2010 to 2017. Eight survey instruments comprising 30 prevalence estimates were analyzed. ACP discussions between LGBT people and their primary health care providers were rare, with an overall prevalence of 10%. Transgender people were 50–70% less likely than their LGB counterparts to have a living will or to have appointed a healthcare proxy. These results suggest there is a critical need for greater cultural competency among health care providers serving LGBT populations. Social workers can play a key role in advocacy and social justice for LGBT individuals with advanced illness.

Desenvolvimento de um guia rápido para prática de atenção à saúde da população transgênero

Problema: Os direitos fundamentais das pessoas transgênero são negados cotidianamente. Neste cenário, o preconceito age como determinante social de saúde impactando na prevalência de problemas como saúde mental e infecções sexualmente transmissíveis (ISTs). O objetivo foi o desenvolvimento de um sumário de evidências para apoiar o atendimento clínico e embasar a capacitação dos profissionais da Atenção Primária de Saúde de Florianópolis - SC, a fim de melhorar os resultados de saúde dessa população. Métodos: Baseado na ferramenta PACK – interface acessível e intuitiva no modelo pergunte, solicite, aconselhe e trate – já implementada no município de Florianópolis. O método de revisão rápida foi utilizado para busca de evidência, priorizando sumários de prática clínica e protocolos internacionais. Fontes primárias foram utilizadas quando os dados anteriores eram insuficientes ou conflitantes. As perguntas de pesquisa seguiram o acrônimo PICO e a recomendação foi classificada de acordo com a adaptação GRADE do Center of Excellence for Transegender Health. Resultados: Foi criado o Guia Rápido para Prática de Atenção à Saúde da População Transgênero aos moldes do PACK Brasil. O mesmo aguarda aprovação do PACK Brasil e do Ambulatório de Atenção Integral à População Transexual de Florianópolis para futura incorporação do material. Conclusão: Apesar da falta de evidência de qualidade e estudos voltados para a população específica, a existência de diretrizes nesse campo legitima a necessidade de atenção à saúde transgênero, além de auxiliar profissionais de saúde e formuladores de políticas sobre como atender a essas necessidades. Na perspectiva de redução de danos, devemos transpor a barreira do estigma social e institucional para produção de diretrizes consensuais em busca de equidade para população transgênero.

Rapid reviews may produce different results to systematic reviews: a meta-epidemiological study

ObjectiveTo simulate possible changes in systematic review results if rapid review methods were used. Study Design and SettingWe recalculated meta-analyses for binary primary outcomes in Cochrane systematic reviews, simulating rapid review methods. We simulated searching only PubMed, excluding older articles (5, 7, 10, 15, and 20 years before the search date), excluding smaller trials (<50, <100, and <200 participants), and using the largest trial only. We examined percentage changes in pooled odds ratios (ORs) (classed as no important change [<5%], small [<20%], moderate [<30%], or large [≥30%]), statistical significance, and biases observed using rapid methods. ResultsTwo thousand five hundred and twelve systematic reviews (16,088 studies) were included. Rapid methods resulted in the loss of all data in 3.7–44.7% of meta-analyses. Searching only PubMed had the smallest risk of changed ORs (19% [477/2,512] were small changes or greater; 10% [260/2,512] were moderate or greater). Changes in ORs varied substantially with each rapid review method; 8.4–21.3% were small, 1.9–8.8% were moderate, and 4.7–34.1% were large. Changes in statistical significance occurred in 6.5–38.6% of meta-analyses. Changes from significant to nonsignificant were most common (2.1–13.7% meta-analyses). We found no evidence of bias with any rapid review method. ConclusionSearching PubMed only might be considered where a ∼10% risk of the primary outcome OR changing by >20% could be tolerated. This could be the case in scoping reviews, resource limitation, or where syntheses are needed urgently. Other situations, such as clinical guidelines and regulatory decisions, favor more comprehensive systematic review methods.

Performance of rapid prescreening and 100% rapid review as internal quality control methods for cervical cytopathology.

An objective of quality control for cervical cytopathology is reducing high rates of false-negative results of laboratory tests. Therefore, methods to review smears such as rapid prescreening and 100% rapid review, which have shown better performance detecting false-negative results, have been widely used. The performance of rapid prescreening and the performance of 100% rapid review as internal quality control methods for cervical cytology examinations were evaluated. For 24 months, 9318 conventional cervical cytology smears underwent rapid prescreening and routine screening. The 100% rapid review method was performed for 8244 smears classified as negative during routine screening. Any discordant results underwent detailed review to define the final diagnosis. This was considered the gold standard for evaluating the performance of rapid prescreening and 100% rapid review. Routine screening showed increases of 13.3% and 11.5% in the detection of abnormal smears with rapid prescreening and 100% rapid review, respectively. The relative percentage variation showed a 38.1% increase in the diagnosis of atypical squamous cells of undetermined significance with routine screening and rapid prescreening and a 12.5% increase in the diagnosis of atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion with both rapid prescreening and 100% rapid review. Sensitivity rates of rapid prescreening and routine screening were 48.2% and 83.2%, respectively. Sensitivity rates of rapid prescreening and 100% rapid review were 65.7% and 57.8%, respectively, for detecting false-negative results. Inclusion of rapid prescreening and/or 100% rapid review improved the diagnostic sensitivity of the cervical cytology examination and reduced false-negative results of routine screening and can provide good quality control.

Application of evidence-based rapid review in studying nephrotoxicity of Tripterygium wilfordii preparation

To investigate the feasibility of applying the evidence-based rapid review in studying the nephrotoxicity of Tripterygium wilfordii preparation. We used four methods in relevant studies on the nephrotoxicity of T. wilfordii preparation. The first method had no limitation on any search terms， which was a traditional approach to retrieve systematic reviews. The second method limited the relevant search terms of T. wilfordii preparation to "all of CHMs containing T. wilfordii preparation approved by CFDA". The third method was to limit the relevant retrieval terms of nephrotoxicity as the "most frequently reported terms related to nephrotoxicity found in the study literature screening process in the early stage of systematic review". The fourth method was to limit the search terms relating to both T. wilfordii preparation and nephrotoxicity. Finally， the results of the last three search methods were compared with those of the first search method， and the feasibility of the rapid review method in the study for the nephrotoxicity of CHM was discussed. For the total number of literatures searched， the fourth method had the smallest number of literatures. For the number of articles in line with the inclusion criteria， the second method had the largest number of eligible literatures. For the type of literatures included， the forth method had a higher coincidence degree. The forth method was the best one， because it was not only consistent with the results， but also could minimize the workload. Rapid review is feasible in the study of nephrotoxicity of T. wilfordii.

Methods for a rapid systematic review and metaanalysis in evaluating selective serotonin reuptake inhibitors for premature ejaculation

The aim of this study was to evaluate a rapid systematic review method in which randomised controlled trial (RCT) data was extracted from existing reviews and subsequent RCTs. The method enabled: identification of RCTs not included by existing reviews; cross-checking RCT data for consistency where there was more than one review; double data extraction due to time saved by extracting data from existing reviews; correction of data synthesis errors in existing reviews; and pooling data across all RCTs to produce contemporary effect estimates. When subsequently compared to extracting data directly from all RCT original publications, the findings and conclusions concurred.

Improving well-being and outcomes for looked after children in Wales: a context sensitive review of interventions

Improving outcomes for looked after children and young people has been a longstanding concern in Wales. This article reports the findings of a scoping study which sought to identify interventions aimed at improving outcomes for looked after children that are effective or promising. The study was commissioned by an independent funding body to inform a £5 million investment programme for Wales. It comprised a rapid review of literature, informed through consultation with an expert advisory panel and groups of young people who had been in care. The article outlines the rapid review method, provides details of shortlisted interventions and describes the interventions subsequently approved for investment. It concludes that although there are many promising interventions which address the factors associated with poor outcomes for looked after children, the evidence base is weak. It is argued that decision-making on interventions should be informed by appraisal of the empirical evidence available, but should also be guided by professional judgement that considers the needs, priorities and preferences of service users, carers, practitioners and policy-makers.

Gender inequalities in environmental health: An interdisciplinary research network on relevance, interdisciplinary approaches and transdisciplinary perspectives

Introduction: A systematic consideration of gender inequalities in environmental exposures and their health impacts is still missing. It is assumed that systematic integration of both biological and social dimensions of sex/gender and their interactions into health research will enhance significance and validity. Methods: An interdisciplinary research network GeUmGe-NET, funded by the Federal Ministry of Education and Research in Germany, was created. By applying the rapid review-method the current state of knowledge, underlying concepts, and methods used in research on sex/gender and environmental health are systematically evaluated. The network will develop interdisciplinary approaches to integrate theoretical concepts of sex/gender into environmental health research, and discuss implications for environmental health monitoring and protection by environment and health authorities. Results: Researchers from environmental epidemiology, toxicology, environmental medicine, public health, gender studies and social-ecological gender research constitute the network. In a first workshop (Feb 2016) a common agreement on terms and concepts was developed and examples of good practice as well as knowledge gaps were discussed. The network identified a mismatch between theoretical concepts and analytical approaches used in practice. Contrary to gender theorized as a multidimensional, context-specific factor that changes according to time and place, a homogeneous dichotomic category measured by a single check box is often used in research. The assessment of how sex/gender is currently considered in biomedical and public health research on environmental health is ongoing. Conclusions: The network will provide potentials for further development of methodology in the field of environmental health research by integrating sex/gender concepts. Recommendations useful for environmental health monitoring, promotion, and protection will contribute to the transfer from science to practice.

A Rapid Review of the Factors Affecting Healthcare Students' Satisfaction with Small-Group, Active Learning Methods

Phenomenon: Problem-based learning (PBL) and other small-group, active learning methodologies have been widely adopted into undergraduate and postgraduate healthcare curricula across the world. Although much research has examined student perceptions of these innovative teaching pedagogies, there are still questions over which factors influence these views. This article aims to identify these key elements that affect healthcare student satisfaction with PBL and other small-group learning methods, including case-based and team-based learning. Approach: A systematic rapid review method was used to identify high-quality original research papers from the healthcare education literature from between 2009 and 2014. All papers were critically appraised before inclusion in line with published guidelines. Narrative synthesis was achieved using an inductively developed, thematic framework approach. Findings: Fifty-four papers were included in the narrative synthesis. The evidence suggests that, despite an initial period of negative emotion and anxiety, the perspectives of healthcare students toward small-group, active learning methods are generally positive. The key factors influencing this satisfaction level include (a) the facilitator role, (b) tutorial structure, (c) individual student factors, (d) case authenticity, (e) increased feedback, (f) group harmony, and (g) resource availability. Insights: Student satisfaction is an important determinant of healthcare education quality, and the findings of this review may be of value in future curriculum design. The evidence described here suggests that an ideal curriculum may be based on an expert-led, hybrid PBL model.

Improvement in the routine screening of cervical smears

High rates of false-negative results constitute a routine problem in cytology laboratories. Of currently available internal quality control methods, 10% random review is the least effective in detecting false-negatives in routine screening. There is evidence that 100% rapid review and rapid prescreening perform well for this purpose. This study compared the performance of rapid prescreening and 100% rapid review as internal quality control methods for cervical cytology exams. Over 27 months, 12,208 cervical cytology smears were submitted to rapid prescreening and routine screening. The 100% rapid review method was performed on all smears classified as negative or unsatisfactory at routine screening. Conflicting results obtained with either method were reviewed in detail to define final diagnosis, which was considered the gold standard for evaluating the performance of rapid prescreening and 100% rapid review. Compared with final diagnosis, the sensitivity of routine screening and rapid prescreening was 72.9% and 75.6%, respectively. Considering only smears classified as negative or unsatisfactory at routine screening, the sensitivity of rapid prescreening and 100% rapid review was 90.2% and 57,0%, respectively. Of 244 cases (2.0%) of false-negative results at routine screening, rapid prescreening identified 220 cases (1.80%), whereas 100% rapid review identified 140 (1.15%). Rapid prescreening detected all cases of HSIL identified as false-negatives. Rapid prescreening is more effective than 100% rapid review for the detection of false-negatives at routine screening, thus providing subsidies for the performance of cervical cytology, the principal function of which is to detect precursor lesions of cervical cancer.

A rapid review method for extremely large corpora of literature: Applications to the domains of modelling, simulation, and management

While literature reviews with a large-scale scope are nowadays becoming a staple element of modern research practice, there are many challenges in taking on such an endeavour, yet little evidence of previous studies addressing these challenges exists. This paper introduces a practical and efficient review framework for extremely large corpora of literature, refined by five parallel implementations within a multi-disciplinary project aiming to map out the research and practice landscape of modelling, simulation, and management methods, spanning a variety of sectors of application where such methods have made a significant impact. Centred on searching and screening techniques along with the use of some emerging IT-assisted analytic and visualisation tools, the proposed framework consists of four key methodological elements to deal with the scale of the reviews, namely: (a) an incremental and iterative review structure, (b) a 3-stage screening phase including filtering, sampling and sifting, (c) use of visualisation tools, and (d) reference chasing (both forward and backward). Five parallel implementations of systematically conducted literature search and screening yielded a total initial search result of 146 087 papers, ultimately narrowed down to a final set of 1383 papers which was manageable within the limited time and other constraints of this research work.

Analysis of the performance of 100% rapid review using an average time of 1 and 2 minutes according to the quality of cervical cytology specimens

To compare the performance of the 100% rapid review method carried out in a mean time of either 1 or 2 minutes according to cytological final result, and to assess whether the presence of obscuring factors in cervical smear samples affects the frequency of false-negative results. A total of 5,235 smears classified as negative (93.0%) or unsatisfactory (2.1%) at routine screening were submitted to 100% rapid review using mean times of 1 and 2 minutes. Of the 5,235 smears submitted to 1-minute rapid review, 88 were considered suspect and of these, 45 were confirmed as abnormal in the cytological final result. When the time used was 2 minutes, 67 smears were considered suspect, 44 of which were confirmed as abnormal. Sensitivity and specificity were similar in the 1- and 2-minute reviews. In smears in which samples were satisfactory and had no obscuring factors, sensitivity and specificity were 64.2% and 98.9% and 61.5% and 99.5% for the 1- and 2-minute reviews, respectively. In comparison, in smears in which the sample was satisfactory for analysis but partially obscured (50-75%), sensitivity and specificity were 64.7% and 99.9% and 70.6% and 99.8% for the 1- and 2-minute reviews, respectively. The method of rapid review of 100% showed no difference in the detection of false-negative results using the time of 1 or 2 minutes. The quality of the sample did not influence the detection of false-negatives.

Comparison of False Negative Rates Between 100% Rapid Review and 10% Random Full Rescreening as Internal Quality Control Methods in Cervical Cytology Screening

To compare and contrast the 100% partial rapid review (RR) method against 10% randomly selected full rescreening to determine the better means of internal quality control (QC) by which the cervical screening laboratory should adopt.A total of 4,150 conventional Pap smears reported as negative during 2003 were 100% rescreened rapidly in large field jumps. From this cohort, 415 (10%) were selected again randomly for full rescreening. The false negative rates (FNRs) were calculated and compared accordingly.The 100% RR method reclassified 30 false negative (FN) cases, while the 10% random full rescreening reclassified only 5. The FNRs were calculated to be 8.2% and 12.9%, respectively. A chi2 test (p < 0.05) showed significant difference between the FNRs calculated by both methods.The 100% RR proved to be a better method for QC purpose in reducing the FNRs and detected more missing cases. This study is the first of its type from Hong Kong and confirms previous publications from elsewhere that 100% RR is a better method for internal QC in cervical cytology screening.

Rapid review (partial rescreening) of cervical cytology. Four years experience and quality assurance implications.

To determine the sensitivity of the partial rescreening method of rapid review for internal quality control of cervical cytology; to determine which staff members are most suited to undertake it; and to investigate the cell patterns of false negative smears previously detected by the method. As a prospective study 9517 cervical smears were partially screened by four cytotechnologists using the 'step' method prior to conventional screening and the results compared with the final report. As a retrospective study 62 false negative smears that had been identified by the method over four years were reviewed. A detection rate for dyskaryosis of 86% (range 82-91%) was achieved. Sixteen abnormal smears were missed on conventional screening that had been detected by prescreening. Review of the 62 false negatives revealed three patterns: (1) scanty abnormal cells; (2) abundant dyskaryotic cells presenting as "microbiopsies"; and (3) abundant, readily recognisable abnormal cells. Partial rescreening enables the detection of errors due to both fatigue and misinterpretation. In this laboratory the method has, together with targeted full rescreening, reduced the false negative report rate from 5.0% to 0.4%. For laboratories using a rapid review method to reduce false negative reports, a prescreening trial is recommended in order (1) to select the most effective review method and the staff most suited to undertake it; and (2) to determine the laboratory's sensitivity with the method, as this is required for accurate estimation of the false negative rate.