In:
International Journal of Technology Assessment in Health Care, Cambridge University Press (CUP), Vol. 34, No. 3 ( 2018), p. 337-342
Abstract:
Colposcopes are expensive, heavy, and need specialized technical service, which may outreach the capacity of low-resource settings. Our aim was to assess the performance of smartphone-based digital images for the detection of cervical intraepithelial neoplasia grade 2 or worse (CIN2+). Methods: Human papillomavirus (HPV)-positive women recruited through a cervical cancer screening campaign had VIA/VILI assessment (visual inspection after application of acetic acid/lugol's iodine). Cervical digital images were captured with a smartphone camera, randomly coded with no prior selection and distributed on an online database (Google Forms) for evaluation. Healthcare providers were invited to evaluate the images and identify CIN2+. The gold standard was the histopathological diagnosis. The sensitivity and specificity for the detection of CIN2+ was assessed for each reader and reported with the 95 percent confidence interval (Clopper-Pearson method). Results: One hundred twenty-five consecutive HPV-positive women were included, with 19 CIN2+ (15.2 percent). Forty-five gynecologists completed the assessment, one-third were considered as experts ( 〉 50 colposcopies) and two-thirds as novices ( 〈 50 colposcopies). The sensitivity and specificity for CIN 2+ detection was 71.3 percent (67.0–75.7 percent) and 62.4 percent (57.5–67.4 percent), respectively. The performance of novices and experts was similar. The readers assessed 73.1 percent of images as acceptable for diagnostic. Conclusion: Smartphone-based digital images, with its high portability, have a great potential for the diagnosis of CIN2+ in low-resource context.
Type of Medium:
Online Resource
ISSN:
0266-4623
,
1471-6348
DOI:
10.1017/S0266462318000260
Language:
English
Publisher:
Cambridge University Press (CUP)
Publication Date:
2018
detail.hit.zdb_id:
2020486-3
