Inter- and intra-observer agreement in the assessment of the cervical transformation zone (TZ) by visual inspection with acetic acid (VIA) and its implications for a screen and treat approach: a reliability study
Rattachement africain : ch, us, Cameroun, pe, Zambie, Côte d’Ivoire. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
BACKGROUND: In low-resource countries, interpretation of the transformation zone (TZ) using the classification of the International Federation for Cervical Pathology and Colposcopy (IFCPC), adopted by the World Health Organization, is critical for determining if visual inspection with acetic acid (VIA) screening and thermal ablation treatment are possible. We aim to assess inter- and intra-observer agreement in TZ interpretation. METHODS: We performed a prospective multi-observer reliability study. One hundred cervical digital images of Human papillomavirus positive women (30-49 years) were consecutively selected from a Cameroonian cervical cancer screening trial. Images of the native cervix and after VIA were obtained. The images were evaluated for the TZ type at two time points (rounds one and two) by five VIA experts from four countries (Côte d'Ivoire, Cameroon, Peru, and Zambia) according to the IFCPC classification (TZ1 = ectocervical fully visible; TZ2 = endocervical fully visible; TZ3 = not fully visible). Intra- and inter-observer agreement were measured by Fleiss' kappa. RESULTS: Overall, 37.0% of images were interpreted as TZ1, 36.4% as TZ2, and 26.6% as TZ3. Global inter-observer reliability indicated fair agreement in both rounds (kappa 0.313 and 0.288). The inter-observer agreement was moderate for TZ1 interpretation (0.460), slight for TZ2 (0.153), and fair for TZ3 (0.329). Intra-observer analysis showed fair agreement for two observers (0.356 and 0.345), moderate agreement for two other (0.562 and 0.549), and one with substantial agreement (0.728). CONCLUSION: Interpretation of the TZ using the IFCPC classification, adopted by the World Health Organization, is critical for determining if VIA screening and thermal ablation treatment are possible. However, the low inter- and intra-observer agreement suggest that the reliability of the referred classification is limited in the context of VIA. It's integration in treatment recommendations should be used with caution since TZ3 interpretation could lead to an important referral rate for further evaluation. Trial registration Cantonal Ethics Board of Geneva, Switzerland: N°2017-0110. Cameroonian National Ethics Committee for Human Health Research N°2018/07/1083/CE/CNERSH/SP.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Inter- and intra-observer agreement in the assessment of the cervical transformation zone (TZ) by visual inspection with acetic acid (VIA) and its implications for a screen and treat approach: a reliability study
- Date Crossref
- 19/01/2023
- Éditeur
- Springer Science and Business Media LLC
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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University of Geneva pays non établi dans la noticeUniversité ou école supérieure
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University Hospital of Geneva pays non établi dans la noticeÉtablissement de santé
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Geneva College pays non établi dans la noticeUniversité ou école supérieure
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Université de Dschang Université de Dschang, Cameroun (code pays fourni par la source)Université ou école supérieure
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University of Piura pays non établi dans la noticeUniversité ou école supérieure
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University Teaching Hospital Zambie (code pays fourni par la source)Établissement de santé
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University of Zambia Lusaka, Zambie (code pays fourni par la source)Université ou école supérieure
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Centre Hospitalier Universitaire de Yopougon Côte d’Ivoire (code pays fourni par la source)Établissement de santé
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National Institutes of Health pays non établi dans la noticeOrganisme public
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National Cancer Institute Department of Health and Human Services pays non établi dans la noticeOrganisme public
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Foundation for laboratory medicine pays non établi dans la noticeOrganisation à but non lucratif
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Faculty of Medicine Department of Obstetrics and Gynecology University of Dschang, Cameroun (pays nommé en fin d’affiliation)Université ou école supérieure
University of Geneva, University Hospital of Geneva et Geneva College, avec 9 autres affiliations. Pays d’affiliation : Cameroun, Zambie, Côte d’Ivoire.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.