MAVARIC was a randomised controlled trial designed to investigate the utility of automation-assisted reading of cervical cytology slides.
73 266 liquid-based cytology samples were obtained from women aged 25–64 years undergoing primary cervical screening in the UK. Women were randomly assigned to receive either manual reading only or paired reading (automation-assisted reading and manual reading). In the paired arm, two automated systems were used—the ThinPrep Imaging System and the FocalPoint GS Imaging System. The primary outcome was sensitivity of automation-assisted reading relative to manual reading for the detection of underlying CIN2+ in the paired arm.
Automation-assisted reading was 8% less sensitive than manual reading and specificity increased by 0·6%. The inferior sensitivity of automation-assisted reading for the detection of CIN2+, combined with an inconsequential increase in specificity, suggests that automation-assisted reading cannot be recommended for primary cervical screening.