TY - JOUR
T1 - Fluorescence spectroscopy for diagnosis of squamous intraepithelial lesions of the cervix
AU - Mitchell, Michele Follen
AU - Cantor, Scott B.
AU - Ramanujam, Nirmala
AU - Tortolero-Luna, Guillermo
AU - Richards-Kortum, Rebecca
N1 - Funding Information:
Supported by the National Science Foundation and the Whitaker Foundation.
PY - 1999/3
Y1 - 1999/3
N2 - Objective: To calculate receiver operating characteristic (ROC) curves for fluorescence spectroscopy in order to measure its performance in the diagnosis of squamous intraepithelial lesions (SILs) and to compare these curves with those for other diagnostic methods: colposcopy, cervicography, speculoscopy, Papanicolaou smear screening, and human papillomavirus (HPV) testing. Data Sources: Data from our previous clinical study were used to calculate ROC curves for fluorescence spectroscopy. Curves for other techniques were calculated from other investigators' reports. To identify these, a MEDLINE search for articles published from 1966 to 1996 was carried out, using the search terms 'colposcopy,' 'cervicoscopy,' 'cervicography,' 'speculoscopy,' 'Papanicolaou smear,' 'HPV testing,' 'fluorescence spectroscopy,' and 'polar probe' in conjunction with the terms 'diagnosis,' 'positive predictive value,' 'negative predictive value,' and 'receiver operating characteristic curve.' Methods of Study Selection: We found 270 articles, from which articles were selected if they reported results of studies involving high-disease-prevalence populations, reported findings of studies in which colposcopically directed biopsy was the criterion standard, and included sufficient data for recalculation of the reported sensitivities and specificities. Tabulation, Integration, and Results: We calculated ROC curves for fluorescence spectroscopy using Bayesian and neural net algorithms. A meta-analytic approach was used to calculate ROC curves for the other techniques. Areas under the curves were calculated. Fluorescence spectroscopy using the neural net algorithm had the highest area under the ROC curve, followed by fluorescence spectroscopy using the Bayesian algorithm, followed by colposcopy, the standard diagnostic technique. Cervicography, Papanicolaou smear screening, and HPV testing performed comparably with each other but not as well as fluorescence spectroscopy and colposcopy. Conclusion: Fluorescence spectroscopy performs better than colposcopy and other techniques in the diagnosis of SILs. Because it also permits real-time diagnosis and has the potential of being used by inexperienced health care personnel, this technology holds bright promise.
AB - Objective: To calculate receiver operating characteristic (ROC) curves for fluorescence spectroscopy in order to measure its performance in the diagnosis of squamous intraepithelial lesions (SILs) and to compare these curves with those for other diagnostic methods: colposcopy, cervicography, speculoscopy, Papanicolaou smear screening, and human papillomavirus (HPV) testing. Data Sources: Data from our previous clinical study were used to calculate ROC curves for fluorescence spectroscopy. Curves for other techniques were calculated from other investigators' reports. To identify these, a MEDLINE search for articles published from 1966 to 1996 was carried out, using the search terms 'colposcopy,' 'cervicoscopy,' 'cervicography,' 'speculoscopy,' 'Papanicolaou smear,' 'HPV testing,' 'fluorescence spectroscopy,' and 'polar probe' in conjunction with the terms 'diagnosis,' 'positive predictive value,' 'negative predictive value,' and 'receiver operating characteristic curve.' Methods of Study Selection: We found 270 articles, from which articles were selected if they reported results of studies involving high-disease-prevalence populations, reported findings of studies in which colposcopically directed biopsy was the criterion standard, and included sufficient data for recalculation of the reported sensitivities and specificities. Tabulation, Integration, and Results: We calculated ROC curves for fluorescence spectroscopy using Bayesian and neural net algorithms. A meta-analytic approach was used to calculate ROC curves for the other techniques. Areas under the curves were calculated. Fluorescence spectroscopy using the neural net algorithm had the highest area under the ROC curve, followed by fluorescence spectroscopy using the Bayesian algorithm, followed by colposcopy, the standard diagnostic technique. Cervicography, Papanicolaou smear screening, and HPV testing performed comparably with each other but not as well as fluorescence spectroscopy and colposcopy. Conclusion: Fluorescence spectroscopy performs better than colposcopy and other techniques in the diagnosis of SILs. Because it also permits real-time diagnosis and has the potential of being used by inexperienced health care personnel, this technology holds bright promise.
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U2 - 10.1016/S0029-7844(98)00385-8
DO - 10.1016/S0029-7844(98)00385-8
M3 - Review article
C2 - 10075001
AN - SCOPUS:0033105177
SN - 0029-7844
VL - 93
SP - 462
EP - 470
JO - Obstetrics and gynecology
JF - Obstetrics and gynecology
IS - 3
ER -