Evaluation of a digital store-and-forward colposcopic system - a pilot study to assess usability for telemedicine

Abstract

We evaluated the diagnostic reliability of cervical examination using digital colposcopy compared with conventional binocular colposcopy. A total of 315 patients were examined and diagnosed by a colposcopist on-site. During the colposcopic examination, digital camera images were stored on a PC (median five pictures per patient). A second physician, experienced in colposcopy, re-evaluated the initial diagnostic findings using the stored digital images. The primary and secondary findings in each patient were categorized according to the Rome classification system. There was agreement between the primary and secondary examiners in 69% of cases (kappa=0.60). There was no systematic bias in terms of under- or over-rating. The proportion of non-assessable colposcopic examinations was 9%. Digital colposcopy was reliable and provided advantages in terms of a better follow-up examination and internal quality control of the diagnosis. The pilot study suggests that telecolposcopy may provide better training and further education for physicians and students, and may also improve the diagnostic possibilities in gynaecology.

Smartphone Use for Cervical Cancer Screening in Low-Resource Countries: A Pilot Study Conducted in Madagascar

“…Conversely, in a Botswanian study [ 19 ], the diagnostic concordance between nurse VIA and nurse photographic evaluation of VIA was 81%. Moderate agreement (kappa = 0.60) was also reported in a German study, where the primary and secondary examiners agreed in 69% of the cases [ 18 ]. Contrary to these studies, naked-eye visualization of the cervix instead of colposcopy was used in the present study, and this difference may have influenced the results.…”

“…Smartphones, with the ability to take high-quality images and to send information quickly, have a clear advantage over “standard” digital cameras: They are very easy to use, do not need an external light source and permit easy zooming in the photography as well as very quick and easy comparison of the different pictures taken (native, VIA and VILI). Experience has shown that smartphones have the capacity to monitor subtle cervical changes and to introduce a simple quality assurance process that can probably be easily integrated into a cervical cancer screening program [ 16 – 18 ].…”

Evaluating the use of telemedicine in gynaecological practice: a systematic review

“…The authors concluded that videocolposcopy can provide an accurate diagnosis, reduced travel distance and can enable training of healthcare staff. 25 Schadel et al 44 evaluated the use of digital colposcopy against conventional binocular colposcopy. 44 Three hundred and fifteen patients had a colposcopic assessment onsite and had their images saved which were reviewed by another colposcopist.…”

“… 25 Schadel et al 44 evaluated the use of digital colposcopy against conventional binocular colposcopy. 44 Three hundred and fifteen patients had a colposcopic assessment onsite and had their images saved which were reviewed by another colposcopist. There was agreement between the examiners in 69% of cases (k=0.60).…”

“…The authors concluded that digital colposcopy was reliable and provided advantages in terms of a better follow-up examination and internal quality control of the diagnosis. 44 …”