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Accuracy of optical spectroscopy for the detection of cervical intraepithelial neoplasia and the role of probe placement
Abstract   Open access   Peer reviewed

Accuracy of optical spectroscopy for the detection of cervical intraepithelial neoplasia and the role of probe placement

Jose-Miguel Yamal, Getie A. Zewdie, Scott B. Cantor, Dennis D. Cox, E. Neely Atkinson, Calum MacAulay, Kalatu R Davies and Michele Follen
Journal of women's health (Larchmont, N.Y. 2002), v 21(4), pp A-16-A-16
Apr 2012
DOI: https://doi.org/10.1089/jwh.2012.Ab01 (p16)
url
http://online.liebertpub.com/doi/pdf/10.1089/jwh.2012.Ab01View
SubmittedOpen Access (License Unspecified),  Open

Abstract

Background: Optical spectroscopy has been proposed as an accurate and low-cost alternative for detection of cervical intraepithelial neoplasia. We previously published an algorithm using optical spectroscopy as an adjunct to colposcopy and found good accuracy (100% sensitivity, 71% specificity). Those results depended on measurements taken by an expert colposcopists as well as the colposcopy diagnosis. Objectives: We wanted to determine the impact of colposcopist expertise on the accuracy of spectroscopy, given that there are few highly-trained colposcopists in low-resource settings. Methods: In this study, we trained and tested an algorithm for the detection of cervical intraepithelial neoplasia that did not include the colposcopic diagnosis. Furthermore, we explored the interaction between spectroscopy and colposcopy, examining the importance of probe placement expertise. Results: The colposcopic diagnosis-independent spectroscopy algorithm had a sensitivity of 0.98 [95% confidence interval(CI)=0.89–1.00] and a specificity (correctly identifying those patients who had histology reading CIN 1 or better) of 0.62 [95%CI=0.52–0.71]. The difference in the partial area under the ROC curves between spectroscopy with and without the colposcopic diagnosis was not statistically significant (p=0.43). Additionally, spectroscopy accuracy was independent of the placement expertise of colposcopists. Conclusions: This shows promise for the use of spectroscopy in low-resource settings where expert colposcopists are not widely available, and for the possible use of methods of probe placement that rely less on precise identification of abnormalities prior to spectroscopic measurement.

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