Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Faculty of Medical Sciences, Department of Gynecology and Obstetrics, University of Kragujevac, Kragujevac, Serbia.
PLoS One. 2024 Oct 31;19(10):e0312870. doi: 10.1371/journal.pone.0312870. eCollection 2024.
Women who receive a result of an abnormal Papanicolaou (Pap) smear can fail to participate in follow up procedures, and this is often due to anxiety. This study aimed to apply artificial neural networks (ANN) in prediction of anxiety in women with an abnormal Pap smear test, prior to and following diagnostic procedures.
One hundred-seventy two women who received an abnormal Pap screening result took part in this study, completing a questionnaire about socio-demographic characteristics and Hospital Anxiety and Depression Scale (HADS), right before and two to four weeks after diagnostics (i.e. colposcopy/biopsy/endocervical curettage). A feedforward back-propagation multilayer perceptron model was applied in analysis.
Prior to diagnostic procedures 50.0% of women experienced anxiety, while after diagnostics anxiety was present in 61.6% of women. The correlation-based feature selection showed that anxiety prior to diagnostic procedures was associated with the use of sedatives, worry score, depression score, and score for concern about health consequences. For anxiety following diagnostics, predictors included rural place of residence, depression score, history of spontaneous abortion, and score for tension and discomfort during colposcopy. The ANN models yielded highly accurate anxiety prediction both prior and after diagnostics, 76.47% and 85.30%, respectively.
The presented findings can aid in identification of those women with a positive Pap screening test who could develop anxiety and thus represent the target group for psychological support, which would consequently improve adherence to follow-up diagnostics and enable timely treatment, finally reducing complications and fatal outcome.
接受巴氏涂片（Pap）异常结果的女性可能无法参与后续检查，这通常是由于焦虑。本研究旨在应用人工神经网络（ANN）预测巴氏涂片异常女性的焦虑，在诊断程序之前和之后。
172 名接受巴氏筛查异常结果的女性参与了本研究，在诊断前（即阴道镜检查/活检/宫颈刮宫术）和诊断后 2 至 4 周完成了一份关于社会人口特征和医院焦虑抑郁量表（HADS）的问卷。应用前馈反向传播多层感知器模型进行分析。
在诊断程序之前，50.0%的女性经历了焦虑，而在诊断后，61.6%的女性出现了焦虑。基于相关性的特征选择表明，在诊断前的焦虑与使用镇静剂、担忧评分、抑郁评分以及对健康后果的担忧评分有关。对于诊断后的焦虑，预测因素包括农村居住地、抑郁评分、自然流产史以及阴道镜检查时的紧张和不适评分。ANN 模型在诊断前和诊断后均能高度准确地预测焦虑，分别为 76.47%和 85.30%。
本研究结果可辅助识别巴氏涂片筛查阳性的女性中可能出现焦虑的人群，从而为心理支持提供目标群体，从而提高对后续诊断的依从性，并能够及时治疗，最终减少并发症和致命结局。
