The Pittsburgh Press from Pittsburgh, Pennsylvania • Page 29

The Pittsburgh Press Section Friday, July 19, 1985 Computer may curb Pap smear errors "IvM VtW' laid By Jon Van i 1 i 1 il ml Mr Mini -in nurti'i'imWn'riirr'-i niii ii jfitimriitnt ffflr ff 'fimlV itt 'Mhfiiir Bill WadeThe Pittsburgh Press No flashy displays, just floor-to-ceiling records and MTV playing all day long at Stedeford's By Pete Bishop The Pittsburgh Press Independent record shops compete by being different Knight-News-Tribune CHICAGO The Pap smear, one of medicine's oldest and most established screening tests, is joining the computer age. The procedure, developed by and named for Dr. George N. Papanicolaou more than 50 years ago, requires physicians to scrape or aspirate samples of tissue from the lower female genital tract. The tissue samples are sent to a laboratory, where a pathologist examines them for signs of abnormalities that indicate cervical cancer or cancer-like lesions.

It is one of the most successful preventive procedures in medicine because when discovered early, cervical cancer responds readily to treatment. Yet physicians are concerned because some women are diagnosed with advanced cervical cancer even though a Pap smear taken a year or two earlier gave them a clean bill of health. The frequency of these "false negative" Pap results is a subject of concern and controversy in medicine. In a recent exchange of letters to the editor of the Journal of the American Medical Association, Drs. Julian De Lia and G.

Berry Schumann of the University of Utah commented on the varying estimates of false negative results. "The incidence of false-negative Papanicolaou smears in the face of biopsy-proved dysplasia (tissue abnormality) has been reported to be as high as 73 percent," De Lia and Schumann wrote. "Equally distressing is the number of anecdotal reports of invasive cancer following several recent normal smears. "According to one recent review, approximately 25 to 30 percent of patients who developed invasive cancer do so within three years or less after negative screenings." At the spring meeting of the American Society of Clinical Pathologists held in Chicago in April, Dr. Robert Hasselbrack, a Seattle pathologist, estimated the false negative Pap rate at 1 in 3.

Several gynecologists question whether false negatives are really that high. "That certainly isn't our experience," said Dr. Antonio Scommegna, chairman of obstetrics and gynecology at Michael Reese Medical Center in Chicago. "The experience across the country may be higher than ours, but I doubt the figure is above the 15 to 20 percent range." Dr. Arthur Herbst, chairman of obstetrics and gynecology at the University of Chicago, said individual studies may document high rates of false negative Pap smears, but the overall rate is probably no more than 10 percent.

"If anything, people practicing in the community tend to overread smears," suspecting an abnormality when none is present, Herbst said. Whatever the incidence of diagnostic failure associated with Pap smears, computerizing the procedure holds promise of making it more accurate and of providing a better-informed prognosis for a patient who does have abnormal cell tissue. At the pathology meeting, Hasselbrack reported on using a computer program to organize Pap information provided by his lab to gynecologists in the community. The reports not only provide a summary of what was found in analyzing the smear, but they include future recommendations for the patient and provide preprinted postcards to send to patients whose smears suggested that further testing is needed to confirm possible cancer. Hasselbrack said an important aspect of computerizing the Pap information is the "index of smear quality" provided to the physician.

Unless the smears comprise at least three different kinds of cells, they won't yield reliable results. Hasselbrack's index tells each physician the quality of a smear and how it compares to all other smears submitted to the lab. Doctors who see that their smears are consistently of low quality compared with those taken by colleagues will improve their techniques, Hasselbrack said. As a result of the index, the general quality of smears submitted for analysis has improved significantly in the year the system has been computerized, Hasselbrack reported. The University of Chicago has used a similar computerized system for 2 years, said Dr.

Marluce Bibbo, a professor of gynecology and pathology, and found it to be helpful. "It's a good thing that computerized record-keeping is getting into the labs that serve community physi- Pleifse see Pap. D2 of the four that doesn't have a store Downtown. During a recent noontime, the National Record Mart near Market Square, the Record Outlet on Fifth Avenue and the Oasis at the corner of Wood Street and Oliver Avenue were filled with lunch-hour buyers and browsers. Only Kaufmann's of the city's three major department stores still sells records, and it sells them Downtown exclusively.

But department stores such as Gold Circle, Sears, Zayre, Hills and Murphy's Mart sell records and share with the chains the advantage of free parking plus having records under the same roof as hardware, underwear, lampshades and lipstick. While Mom's looking at drapes and sheers, Sissy's looking at Tears for Fears. While Dad's buying prints, Junior's buying Prince. The second reason for the success of the chains is the number of stores. National Record Mart has 10 stores in Allegheny County, Record Outlet seven and Oasis five.

Camelot's three district stores are in Century III Mall, West Mifflin; Westmoreland Mall, Greensburg; and Franklin Mall, Washington, Pa. Records, with stores in Springdale and Monroeville, is the only independent with two stores. The third reason is an outgrowth of the second. Because they do such a large volume of business, they can afford large newspaper ads and numerous radio spots and can afford to sell some currently hot records at almost cost to get customers into the store where they just might Please see Records. D2 RECORD GRAVEYARD has neither neon lights nor eye-grabbing displays of album jackets in its sidewalk-level window simply because it's not on sidewalk level.

It's up a narrow flight of rickety stairs above the Panther Hollow Inn near the corner of Forbes Avenue and Craig Street in Oakland. The streetside windows are decorated with skeletons and tombstones. The carpet, in spots, is threadbare to the point of shabbiness. Yet the tiny store will celebrate its sixth anniversary in September. Equally minuscule and inconspicuous is Stedeford's Record Shop, snuggled among bars and pawnshops on East Ohio Street on the North Side.

But it's been in business, although under different ownership and in a different location, since the mid-'40s. Unlike those stores, Record-Rama Sound Archives is cavernous, filling the floor above the Sist office at the corner of cKnight and Siebert roads in Ross. It has to be vast because owner Paul Mawhinney estimates it contains close to 2 million singles, albums and tapes. Like Record Graveyard and" Stedeford's, however, you easily could miss it if you didn't know it was there. The building faces east, the entrance to Record-Rama and steps are on the north and there's no huge sign out front.

But Mawhinney's made a living selling records there and previously in Etna and Hampton since 1968. Record clutter is part of appeal at Stedeford's and other independents centers or malls, which means both free parking and the chance to attract shoppers who went there primarily for some other purchase. Camelot, which has about 125 stores nationwide, is the only one like National Record Mart, Cam-elot Music, Record Outlet and Oasis Records and Tapes. The big boys are big for three major reasons, the first of which is convenience. Many of their stores are located in shopping They aren't alone.

The Greater Pittsburgh Yellow Pages lists nearly 30 independent record re-tailers, located from McDonald' to Lawrenceville, from Carnegie to West Mifflin. They're in there among the big boys chains Compact disc to take over eventually, retailers say By Ray Potter sense. It's the only format that's compatible with all mediums: audio, visual and computers. The same technology locks into place all three of the communications mediums. "The hardware (the CD player) is down to below $300, and a good turntable will cost you that.

CDs are here to stay." Barb Bullister, assistant manager of Camelot Music's Century III Mall outlet, isn't so sure. On one hand, "the CD key on our register is the highest in the store. As far as CDs taking over the world, I don't know. They're not going to push out albums the way cassettes pushed out the eight-track, at least not in the next few years." (Pittsburgh Press staffer Pete Bishop also contributed to this story.) think it will take longer than five years, especially in this market. I think the consumer has to be prepared and primed and made ready for it." George Tunder, director of purchasing for the 75-store National Record Mart Chain, says there's "no question" CDs are what we all eventually will be listening to.

"It may be a little bit longer" than five years. "The LP is not going to go away immediately, but it will be just like the eight-track. Pittsburgh was the last area to get out of the eight-track business, and I think it will be the last to get out of the LP business." Paul Mawhinney, owner of Record-Rama Sound Archives, Ross, says CDs will "completely annihilate the record industry as we know it. It's the only format that makes encased in plastic, they can't be scratched by a diamond-tipped stylus, smudged by fingerprints or stained by droppings from a peanut butter and jelly sandwich. Although most one-record albums cost less than $10, not including tax, and CDs are at least $12, Kwiker's forecast bears heeding, if only because he successfully played a hunch in 1982 that demand for rented videocassette recordings of popular movies would explode.

He stocked Wherehouse stores with them and watched as the chain became the nation's largest outlet for videocassette rentals. Pittsburgh reaction to Kwiker's prediction is mixed. Bill DePcw, who owns Records in Springdale and Monroeville with his wife, Diane, agrees with Kwiker that compact discs will replace records, "but I Knight-News-Tribune LOUIS A. Kwiker is betting that the public's changing tastes will push conventional record albums out of his company's sound-and-video stores "in five years." Instead, music lovers will buy more expensive compact discs, says the president of Wherehouse Entertainment a 145-store chain based in Gardena, Calif. The reason is that the S-inch-diametcr discs, or CDs for short, are "read" not by a stylus but by a laser beam.

Hence they recreate truer sound because there are no tracking problems. And because they're.