Abstract
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 (sensitivity = 1.00 [95% confidence interval CI = 0.92 to 1.00], specificity = 0.71 [95% CI = 0.62 to 0.79]). Those results used measurements taken by expert colposcopists as well as the colposcopy diagnosis. In this study, we trained and tested an algorithm for the detection of cervical intraepithelial neoplasia (i.e., identifying those patients who had histology reading CIN 2 or worse) that did not include the colposcopic diagnosis. Furthermore, we explored the interaction between spectroscopy and colposcopy, examining the importance of probe placement expertise. The colposcopic diagnosis-independent spectroscopy algorithm had a sensitivity of 0.98 (95% CI = 0.89 to 1.00) and a specificity of 0.62 (95% CI = 0.52 to 0.71). The difference in the partial area under the ROC curves between spectroscopy with and without the colposcopic diagnosis was statistically significant at the patient level (p = 0.05) but not the site level (p = 0.13). The results suggest that the device has high accuracy over a wide range of provider accuracy and hence could plausibly be implemented by providers with limited training.
Original language | English (US) |
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Article number | 047002-1 |
Journal | Journal of biomedical optics |
Volume | 17 |
Issue number | 4 |
DOIs | |
State | Published - Apr 2012 |
Keywords
- Cervical intraepithelial neoplasia
- Diagnosis
- Early detection of cancer
- Sensitivity and specificity
- Uterine cervical neoplasms
ASJC Scopus subject areas
- Electronic, Optical and Magnetic Materials
- Biomaterials
- Atomic and Molecular Physics, and Optics
- Biomedical Engineering