Cervical cancer screening in low-resource settings: a smartphone image application as an alternative to colposcopy
Cervical cancer screening in low-resource settings: a smartphone image application as an alternative to colposcopy
复制标题
DOI：
10.2147/ijwh.s136351
复制
发表时间：
2017-01-01
影响因子：
2.3
通讯作者：
Petignat, Patrick
中科院分区：
文献类型：
--
作者：
Gallay, Caroline;Girardet, Anne;Petignat, Patrick
背景资料：应用醋酸（VIA）和卢戈碘（VILI）后的目视检查是最近在低收入和中等收入国家（LMIC）采用的宫颈癌（CC）筛查方法。创新技术允许使用智能手机应用程序获取VIA和VILI的连续宫颈图像。本研究的目的是评估智能手机图像的质量，以评估的可行性和可用性的移动的应用程序CC筛选在LMIC.Methods：2015年5月至11月，年龄在30-65岁的妇女被招募在马达加斯加的CC筛选活动。邀请人乳头瘤病毒阳性的妇女进行VIA/VILI评估。使用三星Galaxy S5和一个名为“Exam”的应用程序拍摄他们的子宫颈照片，该应用程序旨在获得高质量的图像并按以下顺序对其进行分类：原生，VIA，VILI和治疗后。阴道镜检查的专家被要求评估，如果图片的质量是足够的，以建立诊断和评估的清晰度，重点和zoom.Results：应用程序的使用是简单和直观的，和208张图片自动分类，并记录在病人的文件。在93.3%的病例中，质量被判定为足以诊断。观察者之间的协议是kappa = 0.45（0.23-0.58），对应于一个中等协议的共同规模的kappa value.Conclusion：这个智能手机应用程序允许收购高质量的图像VIA/VILI诊断。患者数据库中的图像分类使其可供现场和非现场专家访问，并允许持续的临床教育。智能手机应用程序可以提供阴道镜检查的替代方案，用于LMIC中的CC筛查。
Background: Visual inspection after application of acetic acid (VIA) and Lugol's iodine (VILI) is a cervical cancer (CC) screening approach that has recently been adopted in low-and middle-income countries (LMIC). Innovative technologies allow the acquisition of consecutive cervical images of VIA and VILI using a smartphone application. The aim of this study was to evaluate the quality of smartphone images in order to assess the feasibility and usability of a mobile application for CC screening in LMIC.Methods: Between May and November 2015, women aged 30-65 years were recruited in a CC screening campaign in Madagascar. Human papillomavirus-positive women were invited to undergo VIA/VILI assessment. Pictures of their cervix were taken using a Samsung Galaxy S5 with an application called "Exam", which was designed to obtain high-quality images and to classify them in the following sequence: native, VIA, VILI and posttreatment. Experts in colposcopy were asked to evaluate if the quality of the pictures was sufficient to establish the diagnosis and to assess sharpness, focus and zoom.Results: The application use was simple and intuitive, and 208 pictures were automatically classified and recorded in the patient's file. The quality was judged as adequate for diagnosis in 93.3% of cases. The interobserver agreement was kappa = 0.45 (0.23-0.58), corresponding to a moderate agreement on the common scale of kappa values.Conclusion: This smartphone application allows the acquisition of good quality images for VIA/VILI diagnosis. The classification of images in a patient database makes them accessible to on-and off-site experts, and allows continuous clinical education. Smartphone applications may offer an alternative to colposcopy for CC screening in LMIC.