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 179
- Downloads 0
Syndrome of Inappropriate Secretion of Antidiuretic Hormone Preceding Guillain-Barré Syndrome
Guillain–Barré Syndrome (GBS) is an inflammatory polyradiculoneuropathy which is known to produce syndrome of inappropriate Secretion of Antidiuretic Hormone (SIADH). However, the hyponatremia is usually seen after the o...
Entropy as an Indicator to Measure Depth of Anaesthesia for Laryngeal Mask Airway (LMA) Insertion during Sevoflurane and Propofol Anaesthesia
Introduction: Assessment of the depth of anaesthesia is fundamental to the anaesthetic practice. Entropy measurement is an objective monitoring and is of two types- Response Entropy (RE) and State Entropy (SE) indicating...
The Relationship between Food Insecurity and Lifestyle in Women with Gestational Diabetes
ABSTRACT Introduction: Gestational Diabetes (GDM) is among the most prevalent disorders during pregnancy, affecting the health of mothers and infants. Aim: To explore the relationship between food insecurity and lifestyl...
Comparative Analysis of Serum Levels of Total Carbohydrates and Protein Linked Carbohydrates in Normal and Diabetic Individuals
ABSTRACT Introduction: Non-enzymatic glycation and enzymatic glycosylation of proteins have been proposed as a major factor in the pathogenesis of diabetic complications by altering structure-function of proteins. Though...
A Three Month Comparative Evaluation of the Effect of Different Surface Treatment Agents on the Surface Integrity and Softness of Acrylic based Soft Liner: An In vivo Study
Introduction: Acrylic based soft liners are cost effective, yet are inferior in durability as compared to silicone based liners. Hence, this study was conducted to evaluate if the softness and surface integrity of acryli...