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Portable Pocket colposcopy performs comparably to standard-of-care clinical colposcopy using acetic acid and Lugol's iodine as contrast mediators: an investigational study in Peru.

Publication ,  Journal Article
Mueller, JL; Lam, CT; Dahl, D; Asiedu, MN; Krieger, MS; Bellido-Fuentes, Y; Kellish, M; Peters, J; Erkanli, A; Ortiz, EJ; Muasher, LC ...
Published in: BJOG
September 2018

OBJECTIVE: Our goal was to develop a tele-colposcopy platform for primary-care clinics to improve screening sensitivity and access. Specifically, we developed a low-cost, portable Pocket colposcope and evaluated its performance in a tertiary healthcare centre in Peru. DESIGN AND SETTING: Images of the cervix were captured with a standard-of-care and Pocket colposcope at la Liga Contra el Cáncer in Lima, Peru. POPULATION: Two hundred Peruvian women with abnormal cytology and/or human papillomavirus positivity were enrolled. METHODS: Images were collected using acetic acid and Lugol's iodine as contrast agents. Biopsies were taken as per standard-of-care procedures. MAIN OUTCOME MEASURES: After passing quality review, images from 129 women were sent to four physicians who provided a diagnosis for each image. RESULTS: Physician interpretation of images from the two colposcopes agreed 83.1% of the time. The average sensitivity and specificity of physician interpretation compared with pathology was similar for the Pocket (sensitivity = 71.2%, specificity = 57.5%) and standard-of-care (sensitivity = 79.8%, specificity = 56.6%) colposcopes. When compared with a previous study where only acetic acid was applied to the cervix, results indicated that adding Lugol's iodine as a secondary contrast agent improved the percent agreement between colposcopes for all pathological categories by up to 8.9% and the sensitivity and specificity of physician interpretation compared with pathology by over 6.0 and 9.0%, respectively. CONCLUSIONS: The Pocket colposcope performance was similar to that of a standard-of-care colposcope when used to identify precancerous and cancerous lesions using acetic acid and Lugol's iodine during colposcopy examinations in Peru. TWEETABLE ABSTRACT: The Pocket colposcope performance was similar to that of a standard-of-care colposcope when identifying cervical lesions.

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Published In

BJOG

DOI

EISSN

1471-0528

Publication Date

September 2018

Volume

125

Issue

10

Start / End Page

1321 / 1329

Location

England

Related Subject Headings

  • Uterine Cervical Diseases
  • Primary Health Care
  • Point-of-Care Systems
  • Peru
  • Obstetrics & Reproductive Medicine
  • Middle Aged
  • Iodides
  • Image Enhancement
  • Humans
  • Female
 

Citation

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Chicago
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Mueller, J. L., Lam, C. T., Dahl, D., Asiedu, M. N., Krieger, M. S., Bellido-Fuentes, Y., … Ramanujam, N. (2018). Portable Pocket colposcopy performs comparably to standard-of-care clinical colposcopy using acetic acid and Lugol's iodine as contrast mediators: an investigational study in Peru. BJOG, 125(10), 1321–1329. https://doi.org/10.1111/1471-0528.15326
Mueller, J. L., C. T. Lam, D. Dahl, M. N. Asiedu, M. S. Krieger, Y. Bellido-Fuentes, M. Kellish, et al. “Portable Pocket colposcopy performs comparably to standard-of-care clinical colposcopy using acetic acid and Lugol's iodine as contrast mediators: an investigational study in Peru.BJOG 125, no. 10 (September 2018): 1321–29. https://doi.org/10.1111/1471-0528.15326.
Mueller JL, Lam CT, Dahl D, Asiedu MN, Krieger MS, Bellido-Fuentes Y, Kellish M, Peters J, Erkanli A, Ortiz EJ, Muasher LC, Taylor PT, Schmitt JW, Venegas G, Ramanujam N. Portable Pocket colposcopy performs comparably to standard-of-care clinical colposcopy using acetic acid and Lugol's iodine as contrast mediators: an investigational study in Peru. BJOG. 2018 Sep;125(10):1321–1329.
Journal cover image

Published In

BJOG

DOI

EISSN

1471-0528

Publication Date

September 2018

Volume

125

Issue

10

Start / End Page

1321 / 1329

Location

England

Related Subject Headings

  • Uterine Cervical Diseases
  • Primary Health Care
  • Point-of-Care Systems
  • Peru
  • Obstetrics & Reproductive Medicine
  • Middle Aged
  • Iodides
  • Image Enhancement
  • Humans
  • Female