Kim Soo-Nyung, Kim Yun Hwan, Nam Kye-Hyun, Lee Seon-Kyung, Lee Tae Sung, Choi Ho-Sun, Han Sei-Jun, Kim Seung-Cheol
Department of Obstetrics and Gynecology, Konkuk University Hospital, Seoul, Korea.
Department of Obstetrics and Gynecology, Ewha Womans University Mokdong Hospital, Seoul, Korea.
Obstet Gynecol Sci. 2016 May;59(3):227-32. doi: 10.5468/ogs.2016.59.3.227. Epub 2016 May 13.
Digital cervicography systems would be expected to reduce the costs of film cervicography, and provide the opportunity for "telemedicine-based" screening. We aimed to develop web-based digital cervicography system, and validate it compared with conventional film cervicography.
A hundred cases from five centers were prospectively included, and cervical images (analogue, digitalized by scanning analogue, and digital) were taken separately using both analogue (Cerviscope) and digital camera (Dr. Cervicam) in each patient. Nine specialists evaluated the three kinds of images of each case with time interval between evaluations of each image. To validate novel digitalized system, we analyzed intra-observer variance among evaluation results of three kinds of images.
Sixty-three cases were finally analyzed after excluding technically defective cases that cannot be evaluable on analogue images. The generalized kappa for analogue versus digital image was 0.83, for analogue versus scanned image 0.72, and for digital versus scanned image was 0.71; all were in excellent consensus.
Digitalized cervicography system can be substituted for the film cervicography very reliably, and can be used as a promising telemedicine tool for cervical cancer screening.
数字宫颈造影系统有望降低胶片宫颈造影的成本,并为“基于远程医疗”的筛查提供机会。我们旨在开发基于网络的数字宫颈造影系统,并与传统胶片宫颈造影进行比较以验证其有效性。
前瞻性纳入来自五个中心的100例病例,每位患者分别使用模拟相机(Cerviscope)和数码相机(Dr. Cervicam)拍摄宫颈图像(模拟图像、通过扫描模拟图像数字化后的图像以及数字图像)。九位专家对每个病例的三种图像进行评估,每次评估图像之间有时间间隔。为验证新型数字化系统,我们分析了三种图像评估结果之间的观察者内差异。
排除在模拟图像上无法评估的技术缺陷病例后,最终分析了63例病例。模拟图像与数字图像的广义kappa值为0.83,模拟图像与扫描图像的广义kappa值为0.72,数字图像与扫描图像的广义kappa值为0.71;所有结果均具有高度一致性。
数字化宫颈造影系统可以非常可靠地替代胶片宫颈造影,并且可以作为一种有前景的远程医疗工具用于宫颈癌筛查。