Sensitivity of the Colposcopy Exam After Sexual Assault

性侵犯后阴道镜检查的敏感性

• 批准号: 6621371
• 负责人: Marilyn S Sommers
• 金额: $ 26.01万
• 依托单位: UNIVERSITY OF CINCINNATI
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-05-01 至 2005-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6621371
• 关键词: African American; adult human (21+); bioimaging /biomedical imaging; caucasian American; clinical research; endoscopy; female; forensic medicine; human subject; longitudinal human study; photography; racial /ethnic difference; rape; rectum /anus; sex behavior; vagina; women's health

The National Violence Against Women survey reported that 1 of 6 US women have experienced an attempted or completed rape. Each year almost three million women are injured during rape and sexual assault. Because of the success in identifying microscopic genital injury in sexual assaulted children, more practitioners are using a colposcope during the exam of adult females. Colposcopic photos are then used in court testimony to document non-consensual vs. consensual sex. The specific aim of this study is to determine whether experts can accurately predict consensual vs. non-consensual sex from colposcopic photographs. Research questions include: 1) Can experts differentiate between colposcopic photos of women groups of women: those who have experienced consensual vs. non-consensual sex? 2) When viewed as colposcopic photons, what is the difference in number, type and location of injury to the female genitalia and/or anus after consensual versus non-consensual sex? 3) What are the differences in the sensitivity and specificity of colposcopic photos in detecting injury to the female genitalia and/or anus in African-American and White women? The study will involve prospective enrollment of control subjects who will undergo a colposcopic exam following consensual sex. The photographs derived from the exam will be compared to a retrospective review of photographs from unidentified sexual assault survivors. 100 control subjects who are examined after consensual sexual intercourse will be enrolled over the three years of the study. Chart records and colposcopic photos of sexual assault survivors will be reviewed retrospectively and matched to control subjects by ethnicity, age, and time from assault to exam. A panel of five gynecologic and forensic experts will attempt to differentiate between the photographs of women with consensual (n=100) and non-consensual (n=100) attempt to differentiate between the photographs of women with consensual (n=100) and non-consensual (n=100) sex. They will also determine the frequency, type and location of injury to the female genitalia and/or anus after consensual versus non- consensual sex. Sensitivity, specificity, and other statistics describing the raters' ability to differentiate between the two sets of photographs will be calculated. Findings will also support or refute statements by experts that they can differentiate consensual versus non-consensual sex from colposcopy photos. Ultimately the study has the potential to improve evidence-based practice and enhance conviction rates for rape.

全国暴力侵害妇女调查报告说，六分之一的美国妇女经历过强奸未遂或强奸未遂。每年有近300万妇女在强奸和性侵犯中受伤。由于在识别性侵犯儿童的显微生殖器损伤方面取得了成功，更多的从业者在检查成年女性时使用阴道镜。 阴道镜照片然后被用于法庭证词，以记录非自愿与自愿的性行为。这项研究的具体目的是确定专家是否可以准确地预测阴道镜照片的自愿性行为与非自愿性行为。研究问题包括：1）专家们能区分女性群体的阴道镜照片吗：那些经历过自愿性行为和非自愿性行为的人？2)当被视为阴道镜光子时，自愿性行为与非自愿性行为后女性生殖器和/或肛门损伤的数量、类型和位置有何不同？3)阴道镜照片在检测非裔美国人和白色女性生殖器和/或肛门损伤方面的灵敏度和特异性有何差异？本研究将前瞻性招募对照受试者，这些受试者将在双方同意的性行为后接受阴道镜检查。来自考试的照片将与身份不明的性侵犯幸存者的照片进行回顾性审查。在三年的研究中，将招募100名在自愿性交后接受检查的对照受试者。性侵犯幸存者的图表记录和阴道镜照片将被回顾性审查，并与对照组受试者按种族，年龄，一个由五名妇科和法医专家组成的小组将试图区分自愿（n=100）和非自愿（n = 100）的女性照片。非自愿性行为（n=100）。他们还将确定自愿性行为与非自愿性行为后女性生殖器和/或肛门受伤的频率、类型和位置。将计算敏感性、特异性和描述评定者区分两组照片的能力的其他统计数据。研究结果也将支持或反驳专家的说法，即他们可以从阴道镜照片中区分自愿性行为和非自愿性行为。最终，这项研究有可能改善循证实践，提高强奸定罪率。