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52 54 In addition to the technical requirements of sample preparation, laboratories may wish to consider the variation in unsatisfactory sample rates when choosing an LBC platform.
For example, it has been proposed that such efforts are important for achieving the primary goals of NBS: if parents are aware of the benefits, purpose, and process of screening, they may be more likely to respond promptly to requests for additional testing after a positive (abnormal) result or unsatisfactory sample.
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It has been pointed out that many estimators have unsatisfactory sampling properties, especially with small sample sizes [19].
Since unsatisfactory samples played important roles on therapeutic decisions, we also assessed the sensitivity and specificity for the studies which reported unsatisfactory samples (unsatisfactory samples considered to be positive in our classification) and underestimation rate of unsatisfactory samples.
The sensitivity and specificity for the studies data (included unsatisfactory samples) and underestimation rate of unsatisfactory samples were also calculated.
Since unsatisfactory samples (C1) played important roles in influencing diagnostic accuracy of FNAB, we also assessed the pooled sensitivity and specificity for FNAB in the other classification (unsatisfactory samples were regarded as positive) and the underestimation rate of unsatisfactory samples.
Disputes about unsatisfactory samples were among these studies on account of following therapeutic decisions.
In our first classification, unsatisfactory samples (C1) was exluded as most studies did.
In addition, we assessed the influence of unsatisfactory samples on FNAB diagnosis accuracy.
We accounted for this by excluding the unsatisfactory samples from our calculations.
It should be emphasized that we used the approach of Burapa Kanchanabat [ 11] and Etta D. Pisano [ 12] for evaluating the diagnostic performance of FNAB (1. unsatisfactory samples was temporarily excluded; 2. unsatisfactory samples was classified as positive).
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