False-positive and false-negative proficiency test results in cytology

Proficiency tests in cytology classify a certain proportion of cytologists inaccurately. Some competent cytologists fail during the testing procedure ("false-negative proficiency test" or "type I error") while some individuals who should fail do pass the test ("false-positive proficiency test" or "type II error"). In other words, success or failure during proficiency testing may be the consequence of statistical chance. Calculations based on the binomial distribution are presented to show the seriousness of this problem. The analysis demonstrated that increasing the number of slides in the test sets does not necessarily improve the accuracy of the test. For instance, on the 90% ("borderline competent") level, raising the number of slides in one test set from 10 to 20 reduced the accuracy of the test by 6%.