title: Agreement between colposcopic diagnosis and cervical pathology: Siriraj hospital experience.
abstract: OBJECTIVE
  To evaluate the agreement between colposcopic diagnosis and cervical pathology a retrospective chart review was performed.
  
  
  METHODS
  This study included 437 patients who underwent colposcopy and cervical biopsy or conization at Siriraj Hospital from October 2010 - December 2012. The patient clinical characteristics, cervical cytology results, colposcopic diagnoses, cervical pathology results were recorded and correlations between variables were analyzed.
  
  
  RESULTS
  Agreement of colposcopic diagnosis and cervical pathology was matched in 253 patients (57.9%). The strength of agreement with weighted Kappa statistic was 0.494 (p<0.001). Colposcopic diagnoses more often overestimated (31.1%) than underestimated (11%) the cervical pathology. Agreement of colposcopic diagnosis and cervical pathology within 1 grade was found in 411 patients (94.1%). Positive predictive value (PPV) of high grade colposcopy or more was 75.5%, whereas the negative predictive value (NPV) of insignificant and low grade colposcopy was 83.8%. False positives of high grade colposcopy or more were 21%. False negatives of insignificant or low grade colposcopy were 19.1%.
  
  
  CONCLUSIONS
  Strength of agreement between colposcopic diagnosis and cervical pathology was found to be only moderate. A biopsy at colposcopy should be performed at a gold standard level to detect high grade lesions.
authors: Department of Obstetrics and Gynaecology, Gynaecologic Oncology Unit, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand E-mail : suthi.san@mahidol.ac.th.
authors: Molpen
authors: M
authors: Tatiyachonwiphut
authors: Atthapon
authors: A
authors: Jaishuen
authors: Suthi
authors: S
authors: Sangkarat
authors: Somsak
authors: S
authors: Laiwejpithaya
authors: Weerasak
authors: W
authors: Wongtiraporn
authors: Perapong
authors: P
authors: Inthasorn
authors: Boonlert
authors: B
authors: Viriyapak
authors: Malee
authors: M
authors: Warnnissorn
mesh_terms: D000328:Adult; D001706:Biopsy; D002584:Cervix Uteri / Q000473:pathology*; D003127:Colposcopy; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006761:Hospitals; D006801:Humans; D008679:Metaplasia / Q000473:pathology; D011127:Polyps / Q000473:pathology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013785:Thailand; D002583:Uterine Cervical Neoplasms / Q000473:pathology*; D002575:Uterine Cervicitis / Q000473:pathology; D002578:Uterine Cervical Dysplasia / Q000473:pathology*