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Cervical cancer screening by visual inspection with acetic acid - interobserver variability between nurse and physician.

Authors: Bhavana, Sherigar; Anita, Dalal; Geeta, Durdi; Yeshita, Pujar; Hema, Dhumale;

Cervical cancer screening by visual inspection with acetic acid - interobserver variability between nurse and physician.

Abstract

The objective of the study was to evaluate and compare the test performance of visual inspection with acetic acid (VIA) by a physician and nurse so as to evaluate the feasibility and efficacy of training nurses in interpreting VIA.This cross sectional study was conducted in the colposcopy clinic at the University teaching hospital. A total of 406 women who fulfilled the selection criteria underwent VIA done by both physician and nurse and the findings were interpreted independently. This was followed by colposcopy carried out by a gynecologist blinded to the results of VIA and a directed biopsy was taken if indicated. The diagnostic efficacy was calculated separately for physician and nurse using threshold of cervical intraepithelial neoplasia (CIN) 2 and above and concordance of results between the physician and nurse was determined by kappa statistics.VIA by physician had a higher sensitivity (88.9% versus 80.0%) and a higher specificity (69.8% versus 54.9%) with a disease threshold of CIN 2 and above. The concordance of results showed moderate agreement (kappa=0.366).Trained nurses can be an effective alternative human resource for cervical cancer screening using VIA as a preliminary screening method. Intensive training and periodic reinforcement sessions are needed so as to reduce false positive results.

Keywords

Vaginal Smears, Adult, Observer Variation, Nurses, Uterine Cervical Neoplasms, Acetates, Prognosis, Uterine Cervical Dysplasia, Sensitivity and Specificity, Cross-Sectional Studies, Colposcopy, Risk Factors, Physicians, Carcinoma, Squamous Cell, Feasibility Studies, Humans, Mass Screening, Indicators and Reagents, Female, Coloring Agents, Early Detection of Cancer, Acetic Acid

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
31
Top 10%
Top 10%
Top 10%
gold
Related to Research communities
Cancer Research