Intra and Inter-Observer Variability of Transformation Zone Assessment in Colposcopy: A Qualitative and Quantitative Study
Journal Title: Journal of Clinical and Diagnostic Research - Year 2017, Vol 11, Issue 1
Abstract
Introduction: Colposcopy is an important tool in the diagnosis of cervical precancer and early cancer. The assessment of women with abnormal cytology and selection of those who require further therapy or follow up depends on the colposcopic assessment of the Transformation Zone (TZ). Identification of the TZ is thus an important part of this examination. Intra and inter-observer variability is known to be relatively high in the colposcopic interpretation of abnormal features. However, there are hardly any studies on the observer variability in the assessment of the type of TZ. Aim: The present study was conducted with the aim to compare the intra and inter-observer variability of the TZ type classification and the Squamo-Columnar Junction (SCJ) visibility and to quantitatively measure the intra and inter-observer correlations of tracing of the TZ contours. Materials and Methods: Colposcopy images were obtained for a total of 170 cases. They were reviewed by three colposcopists independently. The colposcopists classified the TZ type and also marked the SCJ contours on the images. Each observer independently reviewed the cases on two different instances (few weeks apart) and the result was compiled for intra-observer variation. The intra and inter observer variability on the TZ type was compared using Cohen’s Kappa. This was followed by a quantitative measurement of TZ observation variability using Hausdorff distance. Results: The inter-observer agreement for the TZ type classification was moderate (Kappa= 0.53 to 0.66). The Intra-observer agreement was moderate to strong (0.60 to 0.86). Conclusion: Colposcopic in vivo examination increases the variability in the identification of the TZ when compared to the analysis of recorded images. The disagreement in the TZ type was mostly in categories Type 2 vs Type 3 followed by Type 1 vs Type 2. A computerized quantification method can be used for quality control and training purpose in colposcopy.
Authors and Affiliations
Elizabeth Vallikad, Premalatha Thekkada Siddartha, Kiran Abhijit Kulkarni, Celine Firtion, Payal Keswarpu, Pallavi Vajinepalli, Sarif Naik, Lovi Gupta
Keywords
Related Articles
- EP ID EP328773
- DOI 10.7860/JCDR/2017/21943.9168
- Views 159
- Downloads 0
Unusual Low-grade Occipito-temporal Ganglioglioma with Calcification
ABSTRACT Ganglioglioma (GG) is a rare benign tumour which may present as focal convulsions. Complete resection of the tumour may lead to excellent recovery. The present case report describes the features of a mixed neuro...
Childhood Cancer in Brazil: Characterising from a 15-year Temporal Analysis
ABSTRACT Introduction: Childhood cancer has a high incidence worldwide. Knowing how this disease presents itself in childhood is important for a correct diagnosis. Aim: This study aimed at characterising childhood cancer...
Significance of Tumour Budding with Cytokeratin 20 Immunostaining as a Histopathological Prognostic Marker in Colorectal Adenocarcinoma
ABSTRACT Introduction: Tumour Budding (TB) in Colorectal Carcinoma (CRC) has been studied comprehensively and brought TB into the clinical dominion as an additional prognostic parameter. The tumour aggressiveness with po...
First Permanent Molar Caries and its Association with Carious Lesions in Other Permanent Teeth
ABSTRACT Introduction: Dental caries is most prevalent in first permanent molars and it is bilaterally distributed in permanent maxillary and mandibular molars. It is assumed that dental caries in first permanent molar i...
Apple-Peel Intestinal Atresia Along with Isolated Jejunal Duplication Cyst in a Newborn – An Extremely Rare Case Report and Brief Review
Apple-peel type of intestinal atresia and non-communicating jejunal duplication cyst are rare congenital malformations. The coexistence is not reported in English literature. A five-day-old female neonate having intestin...