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Colposcopy telemedi...
Colposcopy telemedicine: live versus static swede score and accuracy in detecting CIN2+, a cross-sectional pilot study
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- Taghavi, K. (author)
- Univ Bern, ISPM, Bern, Switzerland
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- Banerjee, D. (author)
- Chittaranjan Natl Canc Inst, Dept Gynecol Oncol, Kolkata, India
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- Mandal, R. (author)
- Chittaranjan Natl Canc Inst, Dept Gynecol Oncol, Kolkata, India
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- Kallner, H. K. (author)
- Karolinska Institutet,Danderyd Hosp, Karolinska Inst, Dept Clin Sci, Stockholm, Sweden
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- Thorsell, M. (author)
- Danderyd Hosp, Karolinska Inst, Dept Clin Sci, Stockholm, Sweden
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- Friis, T. (author)
- Uppsala Univ Hosp, Akad Sjukhuset, Uppsala, Sweden
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- Kocoska-Maras, L. (author)
- Uppsala universitet,Karolinska Institutet,Institutionen för kvinnors och barns hälsa
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- Strander, Björn, 1952 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper,Institute of Clinical Sciences,Univ Gothenburg, Sahlgrenska Acad, Dept Clin Sci, Gothenburg, Sweden
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- Singer, A. (author)
- Univ Coll Hosp, London, England
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- Wikstrom, E. (author)
- Danderyd Hosp, Karolinska Inst, Dept Clin Sci, Stockholm, Sweden
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(creator_code:org_t)
- 2018-06-11
- 2018
- English.
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In: Bmc Womens Health. - : Springer Science and Business Media LLC. - 1472-6874. ; 18:1
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Abstract
Subject headings
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- Background: This cross-sectional pilot study evaluates diagnostic accuracy of live colposcopy versus static image Swede-score evaluation for detecting significant precancerous cervical lesions greater than, or equal to grade 2 severity (CIN2+). Methods: VIA or HrHPV positive women were examined using a mobile colposcope, in a rural clinic in Kolkata, India. Live versus static Swede-score colposcopy assessments were made independently. All assessments were by gynecologists, junior or expert. Static image assessors were blinded to live scoring, patient information and final histopathology result. Primary outcome was the ability to detect CIN2+ lesions verified by directed biopsies. Diagnostic accuracy was calculated for live versus static Swede-score in detecting CIN2+ lesions, as well as for interclass correlation. Results: 495 images from 94 VIA positive women were evaluated in this study. Thirteen women (13.9%) had CIN2+ on biopsy. No significant difference was found in the detection of CIN2+ lesions between live and static assessors (area under curve = 0.69 versus 0.71, p = 0.63). A Swede-score of 4+, had a sensitivity of 76.9% (95% CI 46.2-95.0%) and 84.6% (95% CI 54.6-98.1%), for live-and static-image assessment respectively. The corresponding positive predictive values were found to be 90.9% (95% CI 75.7-98.1%) and 92.6% (95% CI 75.7-99.1%). The interclass correlation was good (kappa statistic = 0.60) for the senior static assessors. Conclusions: Swede-score evaluation of static colposcopy images was found to reliably detect CIN2+ lesions in this study. Larger studies are needed to further develop the colposcopy telemedicine concept which may offer reliable guidance in management where direct specialist input is not available. Trial registration: Ethical approval of the study was obtained by the Chittaranjan National Cancer Institute (CNCI) Human Research Ethics Committee (4.311/27/2014).
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reproduktionsmedicin och gynekologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Obstetrics, Gynaecology and Reproductive Medicine (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Arbetsmedicin och miljömedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Occupational Health and Environmental Health (hsv//eng)
Keyword
- Colposcopy telemedicine
- Cervical screening
- Low-resource settings
- Gynocular
- Mobile colposcope
- cervical-cancer incidence
- sub-saharan africa
- interobserver agreement
- visual inspection
- acetic-acid
- hpv
- countries
- cytology
- images
- system
- Public
- Environmental & Occupational Health
- Obstetrics & Gynecology
- Colposcopy telemedicine
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Taghavi, K.
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Banerjee, D.
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Mandal, R.
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Kallner, H. K.
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Thorsell, M.
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Friis, T.
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show more...
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Kocoska-Maras, L ...
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Strander, Björn, ...
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Singer, A.
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Wikstrom, E.
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Obstetrics Gynae ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Health Sciences
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and Occupational Hea ...
- Articles in the publication
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Bmc Womens Healt ...
- By the university
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University of Gothenburg
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Karolinska Institutet
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Uppsala University