Training in Colposcopy: Experience with a Videocolposcopy Test

Cecchini, Silvia; Bonardi, R; Grazzini, Grazia; Iossa, Anna; Cianferoni, Luciano; Scuderi, A.; Rossi, Rafael; Spaggiari, Giorgia; Pane, A; Ciatto, Stefano

doi:10.1177/030089169708300304

Cited by 5 publications

(4 citation statements)

References 2 publications

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“…Other workers have suggested [5][6][7][8] that linking conventional binocular colposcopy and digital imageprocessing systems might improve the reliability of colposcopic diagnosis. The success of digital colposcopy will depend on whether it is easy to integrate into routine practice, and on the reliability of the findings.…”

Section: Discussionmentioning

confidence: 99%

“…Trainees are also not usually able to attend a colposcopic clinic for long enough to see the entire spectrum of highgrade lesions and to become familiar with their possible colposcopic presentation. 8 Progress in video imaging devices, telecommunications and improved image compression techniques has facilitated new telemedicine applications, which have become established in several medical fields, e.g. teleradiology and telepathology.…”

Section: Introductionmentioning

confidence: 99%

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

Schädel

Coumbos

et al. 2005

J Telemed Telecare

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Schädel

Coumbos

et al. 2005

J Telemed Telecare

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“…In frühen gynäkologischen Studien wurde auf das Potenzial einfacher bildgebender Systeme in Form von 35 mm-Fotografien (Colpophotography) [32,33] oder Videoaufnahmen (Videocolposcopy) [34,35] und die damit verbundenen Vorteile für die Befunddokumentation verwiesen. Digitale Kolposkopiesysteme (Digital Imaging Colposcopy) erlauben eine einfache Datenarchivierung [36 ± 44].…”

Section: Introductionunclassified

Digitale Kolposkopie bei Läsionen der Cervix uteri - Eine Pilotstudie unter Berücksichtigung telematischer Fragestellungen

Schädel

Coumbos

Willrodt

et al. 2004

Geburtsh Frauenheilk

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ZusammenfassungZiel: Im Management einer zunehmend komplexen, vernetzten und integrierten Gesundheitsversorgung gewinnen telematische Anwendungen eine immer gröûere Bedeutung. Es sollte die Reproduzierbarkeit der Befundung zervikaler Läsionen anhand digital gespeicherter Bilder im Vergleich zur herkömmlichen binokularen Kolposkopie evaluiert werden. Ziel war es, den Stellenwert der digitalen Kolposkopie für eine ¹Qualitätssicherungª bei der Diagnosestellung durch Verbesserung der ärztlichen Information, Kommunikation sowie der Aus-und Weiterbildungsmöglichkeiten zu untersuchen. Methodik und Patientinnen: Ein binokulares Kolposkop wurde durch eine CCD-Kamera ergänzt. Während der kolposkopischen Untersuchung wurden die Kamerabilder parallel zur Beobachtung am Binokular online an einen PC weitergeleitet und nach den Funktionsproben an der Zervix (Nativ-, Essigsäure-, Jodprobe) gespeichert. Die Reevaluation der primär erhobenen Befunde erfolgte durch einen zweiten in der Kolposkopie erfahrenen Diagnostiker anhand dieser im PC gespeicherten Aufnahmen. Primär-und Sekundärbefunde jeder Patientin wurden in Anlehnung an die Rom-Klassifikation in 4 Befundklassen eingeteilt und verglichen. Insgesamt wurden 315 Patientinnen untersucht und deren Daten statistisch ausgewertet (McNemar-Test, Cohens Kappa-Test). AbstractObjective: The use of telematic applications is becoming increasingly significant for the management of a complex, networked and integrated health service. The aim of this study was to evaluate the reliability of diagnostic findings of the cervix with digital colposcopy compared to standard binocular colposcopy and to assess its significance in the ªquality assuranceº of diagnostics due to improved information and communication between physicians as well as for the purpose of training and further education. Methods and Patients: A binocular colposcope was supplemented with a CCD camera. During colposcopic examination, the camera images were transmitted online to a PC parallel to the binocular observation. After carrying out function tests at the cervix (native, acetic acid, Schiller Test with iodine solution) the images were stored. The re-evaluation of the initial diagnostic findings were made on the basis of these stored digital images by a second physician experienced in colposcopy. Primary and secondary findings of each patient were classified and compared according to the Rome classification system. Altogether, data of 315 patients were acquired and statistically analysed. Results: Agreement between the primary and secondary examiner was detected in 69% of the cases (k = 0.60 0.03). 14% of the deviating diagnostic findings were underrated and 18% over-Originalarbeit 1205 Institutsangaben

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“…In einigen frühen gynäkologischen Studien wurde bereits auf das Potential einfacher bildgebender Systeme in Form von Kleinbildfotografien (Colpophotography) [17,19] oder Videoaufnahmen (Videocolposcopy) [2,6] verwiesen. In einigen frühen gynäkologischen Studien wurde bereits auf das Potential einfacher bildgebender Systeme in Form von Kleinbildfotografien (Colpophotography) [17,19] oder Videoaufnahmen (Videocolposcopy) [2,6] verwiesen.…”

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Die Anwendbarkeit der digitalen Kolposkopie für telematische Fragestellungen / The Suitability of Digital Colposcopy for Telematic Applications

Schädell

Coumbos²,

Ey³

et al. 2004

Biomedizinische Technik/Biomedical Engineering

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Since carcinoma of the cervix is one of the most common cancers in women, screening of the cervix has acquired considerable importance. Colposcopy is a simple diagnostic method of detecting suspicious changes at an early stage. Shortcomings of this method are its low specificity and high inter- and intra-observer variability. A clinical pilot study was therefore carried out to investigate the advantages of a digital colposcopic system comprising a binocular colposcope coupled to a CCD camera and a computer. The aim of the study was to evaluate the reliability of diagnostic findings of the cervix obtained with digital colposcopy in comparison with standard binocular colposcopy, and to assess its suitability for telematic applications (teleconsultation, telediagnostics, treaching). A total of 315 patients were examined and statistically analysed. The patients were first submitted to a conventional colposcopic examination and a diagnosis was established. During the colposcopic examination camera images were stored on a computer, on the basis of which a second physician experienced in colposcopy reviewed the initial diagnosis. The primary and secondary findings of each patient were classified into 4 categories and compared following the Rome classification system. Agreement between the primary and secondary diagnosis was established in 69% of the cases (kappa = 0.60 +/- 0.03). No bias was observed in terms of under- or overrating. The percentage of non-assessable colposcopic examinations was 9.2%. Digital colposcopy is therefore suitable for reproducing diagnostic findings on the computer, given adequate digital image quality and a suitable classification model. The method has clear advantages with regard to follow-up, internal quality control of the diagnosis, and the training and further education of physicians and students. In the future, telecolposcopy may open up new opportunities in gynaecology.

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Training in Colposcopy: Experience with a Videocolposcopy Test

Cited by 5 publications

References 2 publications

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

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

Digitale Kolposkopie bei Läsionen der Cervix uteri - Eine Pilotstudie unter Berücksichtigung telematischer Fragestellungen

Die Anwendbarkeit der digitalen Kolposkopie für telematische Fragestellungen / The Suitability of Digital Colposcopy for Telematic Applications

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