title: Agreement of colposcope and gynocular in assessment of cervical lesions by swede score: a randomized, crossover pilot trial.
abstract: OBJECTIVE
  This study aimed to determine if criterion standard colposcopy could be provided by a pocket-sized battery-driven colposcope, the Gynocular.
  
  
  METHODS
  The study was a randomized, crossover, pilot clinical trial for evaluating agreement of diagnosis of cervical lesions by colposcopy using a standard colposcope and a pocket-sized battery-driven colposcope, the Gynocular, in 69 women positive for visual inspection with acetic acid. Swede scores were used at the time of colposcopy and compared with the final histological diagnosis after directed cervical biopsy. To test the level of agreement between the colposcopy and Gynocular, we calculated the percentage agreement and the κ statistic. We calculated the detection rates of cervical lesions of the Gynocular and a standard colposcope using biopsy results as criterion standards. All included patients also underwent a Pap smear.
  
  
  RESULTS
  The level of agreement of Swede score between the Gynocular and colposcope was 70.1% and the κ statistic was 0.65 (p < .001). Biopsy identified 4 women (6.7%) with cervical intraepithelial neoplasia 1 (CIN 1) and 1 woman (1.7%) with CIN 2; 2 women (3.4%) had CIN 3, and 2 women had invasive cervical cancer (CIN 3+). Pap smear detected 2 women (3.1%) with CIN 1 but did not identify any high-grade cervical lesion. Cervicitis was present in 17 (27.4%) of the Pap smears and in 34 (57.6%) of the biopsies.
  
  
  CONCLUSIONS
  The study shows that in visual inspection with acetic acid-positive women, a battery-driven, pocket-sized colposcope has a significant level of agreement with stationary colposcopy in assessing cervical lesions.
authors: Departments of 1Obstetrics and Gynecology, and 2Community Health Mbarara University of Science and Technology, Mbarara, Uganda; and Departments of 3Obstetrics and Gynecology, and 4Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden.
authors: Joseph
authors: J
authors: Ngonzi
authors: Francis
authors: F
authors: Bajunirwe
authors: Charlotte
authors: C
authors: Wistrand
authors: Ronald
authors: R
authors: Mayanja
authors: Daniel
authors: D
authors: Altman
authors: Malin
authors: M
authors: Thorsell
authors: Elisabeth Andrea
authors: EA
authors: Wikström Shemer
mesh_terms: D000293:Adolescent; D000328:Adult; D003127:Colposcopy / Q000379:methods*; D018592:Cross-Over Studies; D019719:Diagnostic Equipment; D005260:Female; D006801:Humans; D008875:Middle Aged; D010865:Pilot Projects; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D055815:Young Adult