Thirty-four trials and six observational comparative studies were included in a Cochrane review [Abstract] 1. The Ayre spatula was shown to be less effective compared with extended tip spatulas for collecting endocervical cells in eight trials (odds ratio 2.5, 95% CI 2.06 to 2.44). Use of a spatula with the cytobrush was more effective than spatula alone at collecting endocervical cells (odds ratio 3.33, 95% CI 3.05 to 3.63). Extended tip spatulas were also superior for the detection of dyskaryosis in seven trials (odds ratio 1.21, 95% CI 1.10 to 1.33).
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