Web-based instrument to assess skills in visual inspection of the cervix among healthcare providers

Negulescu, Raluca-Anca; Catarino, Rosa; Vuyst, Hugo De; Undurraga-Malinverno, Manuela; Meyer-Hamme, Ulrike; Alec, Milena; Campana, A.; Vassilakos, Pierre; Petignat, Patrick

doi:10.1016/j.ijgo.2015.11.024

Cited by 4 publications

(5 citation statements)

References 19 publications

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“…Confirmation of VIA results through review of VIA photographs by gynecologists and medical officers, confirmation of diagnosis through web-based instruments, and follow-up visits by initial program implementers have all been utilized to assist with program monitoring and evaluation [517]. Repeat trainings and periodic refreshers have been shown to increase average test scores and confirm or improve clinical practices [18].…”

Section: Introductionmentioning

confidence: 99%

Cervical Cancer Screening in HIV-Positive Farmers in South Africa: Mixed-Method Assessment

Lieber

Afzal

Shaia

et al. 2019

Annals of Global Health

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Background: In 2015, a See and Treat cervical cancer screening program was implemented at a local HIV clinic in Limpopo, South Africa, where infrastructure limited adequate Pap smear usability. Objectives: The purpose of this evaluation was to determine the quality and sustainability of the implemented program. Methods: A mixed-methods program analysis was conducted at 18-months post implementation. Data collection techniques included in-depth interviews of staff and patients, observation of healthcare workers delivering screening, and review of charts and patient logs. Findings: Eighteen in-depth interviews revealed improved cervical cancer screening understanding and awareness. Privacy concerns and negative perceptions of medical care were barriers to screening. Informal observations revealed continued clinical competence among healthcare workers who had been previously trained. Review of charts demonstrated positive correlation between VIA and Pap smear results. In evaluating loss to attrition, about half of the first cohort of patients were lost to follow-up. VIAs and Pap smears were offered on an ongoing basis, and month-over-month change for overlapping four months of programming between 2015 and 2016 showed a 4.4% negative change in number of Pap smears and a 57% negative change in VIAs. Conclusion: Our evaluation reveals successful integration of See and Treat into current clinic services in rural South Africa and increased awareness of cervical cancer among health workers and participants. Program sustainability was challenging to assess as many patients were lost to follow-up, given the migrant and transient population attending this clinic. Acceptance by health workers and patients alike is vital for the long-term impact on cervical cancer incidence in this region.

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Section: Introductionmentioning

confidence: 99%

Cervical Cancer Screening in HIV-Positive Farmers in South Africa: Mixed-Method Assessment

Lieber

Afzal

Shaia

et al. 2019

Annals of Global Health

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“…Even though the competence of health professionals to perform screening tests for cervical cancer is important, we found only a few studies that have evaluated it. Most of them evaluated competence according to a checklist completed by specialists after the direct observation of the procedure [ 9 – 11 ], while one evaluated competence using an online test that consisted of clinical cases [ 12 ]. However, we did not find any study that has evaluated self-perceived competence.…”

Section: Discussionmentioning

confidence: 99%

“…Another study was conducted in Switzerland to assess the competency in differentiating between the normal cervix and cervical lesions with VIA and VILI. In order to achieve this, the researchers launched a web portal that included a free test consisting of 70 clinical cases with VIA and VILI images found that of 255 voluntary participants (including physicians, nurses, midwives, and medical students) from more than 100 countries, only two out of five participants passed the test, though this proportion was slightly higher among physicians [ 12 ]. This prevalence was lower than the prevalence of being self-perceived as competent for performing VIA/VILI in our study, although differences in the methodology prevents any comparison.…”

Section: Discussionmentioning

confidence: 99%

“…Studies performed in physicians, nurses and midwives from Morocco [ 10 ]; and in nurses from Ghana, and Thailand [ 11 ] used similar methodologies to assess competencies in the performance of VIA. Another study carried out through a web portal that included a test with images of VIA and VILI, managed to include physicians, nurses, and midwives from more than 100 countries worldwide [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

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Self-perceived competence in early diagnosis of cervical cancer among recently graduated physicians from Lima, Peru

et al. 2018

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ObjectiveTo assess the prevalence of recently graduated physicians who perceived themselves as adequately competent to perform Papanicolaou (PAP), Visual Inspection with Acetic Acid (VIA), and Visual Inspection with Lugol´s Iodine (VILI); and study its associated factors, in Lima, Peru.MethodsThis cross-sectional study evaluated recently graduated physicians from Lima, Peru. Physicians were considered to perceive themselves as adequately competent if they had answered, "agree" or "strongly agree" when asked if they were competent enough to perform these screening tests. To evaluate the associated factors, prevalence ratios (PR) were calculated using Poisson regressions with robust variance.ResultsOnly 367/432 (86.2%) physicians perceived themselves as adequately competent to perform PAP, 257 (60.5%) to perform VIA, and 247 (58.1%) to perform VILI. Physicians who performed their gynecology/obstetric clerkship at hospitals from the police or armed forces had a higher proportion of perceiving themselves as adequately competent to perform VIA and VILI.ConclusionsNine out of ten physicians perceived themselves as adequately competent to perform PAP, while six out of ten to perform VIA or VILI. The health care system in which the physicians performed their clerkship was associated with the prevalence of adequate self-perceived competence for performing VIA and VILI.

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“…Maintaining competencies and accuracies of VIA are also major challenges as the standard short-term onsite VIA trainings may not guarantee skills retention. VIA web-based trainings appear to be tools that can be used for continuous education, to maintain frontline healthcare providers’ skills, which will eventually contribute to a higher diagnosis performance [ 27 , 28 ] ( Table 2 ).…”

Section: On-site Training and Supervisionmentioning

confidence: 99%

Smartphone-Based Visual Inspection with Acetic Acid: An Innovative Tool to Improve Cervical Cancer Screening in Low-Resource Setting

et al. 2022

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Visual inspection with acetic acid (VIA) is recommended by the World Health Organization for primary cervical cancer screening or triage of human papillomavirus-positive women living in low-resource settings. Nonetheless, traditional VIA with the naked-eye is associated with large variabilities in the detection of pre-cancer and with a lack of quality control. Digital-VIA (D-VIA), using high definition cameras, allows magnification and zooming on transformation zones and suspicious cervical regions, as well as simultaneously compare native and post-VIA images in real-time. We searched MEDLINE and LILACS between January 2015 and November 2021 for relevant studies conducted in low-resource settings using a smartphone device for D-VIA. The aim of this review was to provide an evaluation on available data for smartphone use in low-resource settings in the context of D-VIA-based cervical cancer screenings. The available results to date show that the quality of D-VIA images is satisfactory and enables CIN1/CIN2+ diagnosis, and that a smartphone is a promising tool for cervical cancer screening monitoring and for on- and off-site supervision, and training. The use of artificial intelligence algorithms could soon allow automated and accurate cervical lesion detection.

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Web-based instrument to assess skills in visual inspection of the cervix among healthcare providers

Abstract: Web-based training for VIA/VILI is feasible and can identify healthcare workers who are proficient in this technique.

Cited by 4 publications

References 19 publications

Cervical Cancer Screening in HIV-Positive Farmers in South Africa: Mixed-Method Assessment

Cervical Cancer Screening in HIV-Positive Farmers in South Africa: Mixed-Method Assessment

Self-perceived competence in early diagnosis of cervical cancer among recently graduated physicians from Lima, Peru

Smartphone-Based Visual Inspection with Acetic Acid: An Innovative Tool to Improve Cervical Cancer Screening in Low-Resource Setting

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