Article ID Journal Published Year Pages File Type
3952395 International Journal of Gynecology & Obstetrics 2011 11 Pages PDF
Abstract

ObjectiveTo provide an updated estimation of the accuracy of visual inspection with acetic acid (VIA) in detecting true disease.MethodsA PubMed search provided original studies on VIA accuracy in which the gold standard for confirmatory testing was histology alone or colposcopy followed by biopsy. The numbers of true-positive, false-positive, false-negative, and true-negative results were extracted from each study. Meta-analyses were then performed with different categories of studies according to confirmatory diagnosis threshold, category of women who received confirmatory testing, and whether a medical condition that could affect VIA accuracy was present at screening. The reference category consisted of 26 studies in which VIA was performed on asymptomatic women who all underwent confirmatory testing and in which the disease threshold was cervical intraepithelial neoplasia grade 2.ResultsWe report an 80% sensitivity (range, 79%–82%) and a 92% specificity (range, 91%–92%) for VIA. Study region, capacity of screener, or size of the study population did not modify VIA accuracy. The positive predictive value was 10% (range, 9%–10%).ConclusionScreening for precancerous and cancerous cervical lesions using VIA is a simple, low-cost, and efficient alternative to cytologic testing in low-resource areas.

Related Topics
Health Sciences Medicine and Dentistry Obstetrics, Gynecology and Women's Health
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