The efficacy of telecolposcopy compared with traditional colposcopy

Daron Gale Ferris, Michael S Macfee, Jill A. Miller, Mark S. Litaker, Debra Crawley, Diane Watson

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

OBJECTIVE: Rural women have increased rates of cervical neoplasia, but colposcopic services are limited in rural clinics. The purpose of this study was to estimate the efficacy of telecolposcopy for women in rural health care sites. METHODS: Women with an indication for colposcopy were examined by local colposcopists at one of two rural clinics. Images of the colposcopic examination were transmitted to a tertiary care center for interpretation by an expert colposcopist. Another colposcopist (site expert) in attendance at the rural site also examined the same subjects, but did not share findings with the other colposcopists. Colposcopists independently determined the adequacy of the examination, colposcopic impression, biopsy intent and site, and management. Agreement between colposcopic impressions and cervical histology were assessed by using percent agreement, Cohen's κ statistic, and McNemar's test with Bonferroni's adjustment. RESULTS: Teleconsultation was required for 36.2% of colposcopic examinations. A significantly lower percentage of satisfactory colposcopic examinations was noted by the distant colposcopists (60.0%) compared with the other colposcopists (P < .001). Colposcopic impression agreement with histology varied minimally, 59.7% (κ = 0.31) for local colposcopists, 52.7% (κ = 0.22) for site experts, 55.7% (κ = 0.27) for distant experts who concurrently viewed the examination, and 49.7% (κ = 0.16) for distant experts who viewed the examination on videotape at a later time. CONCLUSION: Teleconsultation was used for a substantial number of examinations. Diagnostic accuracy was maintained, but determination of colposcopic examination adequacy may be impaired by telecolposcopy. Telecolposcopy may help reduce barriers to medical access for women in rural areas.

Original languageEnglish (US)
Pages (from-to)248-254
Number of pages7
JournalObstetrics and Gynecology
Volume99
Issue number2
DOIs
StatePublished - Feb 11 2002

Fingerprint

Colposcopy
Remote Consultation
Histology
Rural Health
Videotape Recording
Tertiary Care Centers
Delivery of Health Care
Biopsy
Neoplasms

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Ferris, D. G., Macfee, M. S., Miller, J. A., Litaker, M. S., Crawley, D., & Watson, D. (2002). The efficacy of telecolposcopy compared with traditional colposcopy. Obstetrics and Gynecology, 99(2), 248-254. https://doi.org/10.1016/S0029-7844(01)01671-4

The efficacy of telecolposcopy compared with traditional colposcopy. / Ferris, Daron Gale; Macfee, Michael S; Miller, Jill A.; Litaker, Mark S.; Crawley, Debra; Watson, Diane.

In: Obstetrics and Gynecology, Vol. 99, No. 2, 11.02.2002, p. 248-254.

Research output: Contribution to journalArticle

Ferris, DG, Macfee, MS, Miller, JA, Litaker, MS, Crawley, D & Watson, D 2002, 'The efficacy of telecolposcopy compared with traditional colposcopy', Obstetrics and Gynecology, vol. 99, no. 2, pp. 248-254. https://doi.org/10.1016/S0029-7844(01)01671-4
Ferris, Daron Gale ; Macfee, Michael S ; Miller, Jill A. ; Litaker, Mark S. ; Crawley, Debra ; Watson, Diane. / The efficacy of telecolposcopy compared with traditional colposcopy. In: Obstetrics and Gynecology. 2002 ; Vol. 99, No. 2. pp. 248-254.
@article{d804d4341b72483e8165c1e8e8fd2278,
title = "The efficacy of telecolposcopy compared with traditional colposcopy",
abstract = "OBJECTIVE: Rural women have increased rates of cervical neoplasia, but colposcopic services are limited in rural clinics. The purpose of this study was to estimate the efficacy of telecolposcopy for women in rural health care sites. METHODS: Women with an indication for colposcopy were examined by local colposcopists at one of two rural clinics. Images of the colposcopic examination were transmitted to a tertiary care center for interpretation by an expert colposcopist. Another colposcopist (site expert) in attendance at the rural site also examined the same subjects, but did not share findings with the other colposcopists. Colposcopists independently determined the adequacy of the examination, colposcopic impression, biopsy intent and site, and management. Agreement between colposcopic impressions and cervical histology were assessed by using percent agreement, Cohen's κ statistic, and McNemar's test with Bonferroni's adjustment. RESULTS: Teleconsultation was required for 36.2{\%} of colposcopic examinations. A significantly lower percentage of satisfactory colposcopic examinations was noted by the distant colposcopists (60.0{\%}) compared with the other colposcopists (P < .001). Colposcopic impression agreement with histology varied minimally, 59.7{\%} (κ = 0.31) for local colposcopists, 52.7{\%} (κ = 0.22) for site experts, 55.7{\%} (κ = 0.27) for distant experts who concurrently viewed the examination, and 49.7{\%} (κ = 0.16) for distant experts who viewed the examination on videotape at a later time. CONCLUSION: Teleconsultation was used for a substantial number of examinations. Diagnostic accuracy was maintained, but determination of colposcopic examination adequacy may be impaired by telecolposcopy. Telecolposcopy may help reduce barriers to medical access for women in rural areas.",
author = "Ferris, {Daron Gale} and Macfee, {Michael S} and Miller, {Jill A.} and Litaker, {Mark S.} and Debra Crawley and Diane Watson",
year = "2002",
month = "2",
day = "11",
doi = "10.1016/S0029-7844(01)01671-4",
language = "English (US)",
volume = "99",
pages = "248--254",
journal = "Obstetrics and Gynecology",
issn = "0029-7844",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - The efficacy of telecolposcopy compared with traditional colposcopy

AU - Ferris, Daron Gale

AU - Macfee, Michael S

AU - Miller, Jill A.

AU - Litaker, Mark S.

AU - Crawley, Debra

AU - Watson, Diane

PY - 2002/2/11

Y1 - 2002/2/11

N2 - OBJECTIVE: Rural women have increased rates of cervical neoplasia, but colposcopic services are limited in rural clinics. The purpose of this study was to estimate the efficacy of telecolposcopy for women in rural health care sites. METHODS: Women with an indication for colposcopy were examined by local colposcopists at one of two rural clinics. Images of the colposcopic examination were transmitted to a tertiary care center for interpretation by an expert colposcopist. Another colposcopist (site expert) in attendance at the rural site also examined the same subjects, but did not share findings with the other colposcopists. Colposcopists independently determined the adequacy of the examination, colposcopic impression, biopsy intent and site, and management. Agreement between colposcopic impressions and cervical histology were assessed by using percent agreement, Cohen's κ statistic, and McNemar's test with Bonferroni's adjustment. RESULTS: Teleconsultation was required for 36.2% of colposcopic examinations. A significantly lower percentage of satisfactory colposcopic examinations was noted by the distant colposcopists (60.0%) compared with the other colposcopists (P < .001). Colposcopic impression agreement with histology varied minimally, 59.7% (κ = 0.31) for local colposcopists, 52.7% (κ = 0.22) for site experts, 55.7% (κ = 0.27) for distant experts who concurrently viewed the examination, and 49.7% (κ = 0.16) for distant experts who viewed the examination on videotape at a later time. CONCLUSION: Teleconsultation was used for a substantial number of examinations. Diagnostic accuracy was maintained, but determination of colposcopic examination adequacy may be impaired by telecolposcopy. Telecolposcopy may help reduce barriers to medical access for women in rural areas.

AB - OBJECTIVE: Rural women have increased rates of cervical neoplasia, but colposcopic services are limited in rural clinics. The purpose of this study was to estimate the efficacy of telecolposcopy for women in rural health care sites. METHODS: Women with an indication for colposcopy were examined by local colposcopists at one of two rural clinics. Images of the colposcopic examination were transmitted to a tertiary care center for interpretation by an expert colposcopist. Another colposcopist (site expert) in attendance at the rural site also examined the same subjects, but did not share findings with the other colposcopists. Colposcopists independently determined the adequacy of the examination, colposcopic impression, biopsy intent and site, and management. Agreement between colposcopic impressions and cervical histology were assessed by using percent agreement, Cohen's κ statistic, and McNemar's test with Bonferroni's adjustment. RESULTS: Teleconsultation was required for 36.2% of colposcopic examinations. A significantly lower percentage of satisfactory colposcopic examinations was noted by the distant colposcopists (60.0%) compared with the other colposcopists (P < .001). Colposcopic impression agreement with histology varied minimally, 59.7% (κ = 0.31) for local colposcopists, 52.7% (κ = 0.22) for site experts, 55.7% (κ = 0.27) for distant experts who concurrently viewed the examination, and 49.7% (κ = 0.16) for distant experts who viewed the examination on videotape at a later time. CONCLUSION: Teleconsultation was used for a substantial number of examinations. Diagnostic accuracy was maintained, but determination of colposcopic examination adequacy may be impaired by telecolposcopy. Telecolposcopy may help reduce barriers to medical access for women in rural areas.

UR - http://www.scopus.com/inward/record.url?scp=0036157680&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036157680&partnerID=8YFLogxK

U2 - 10.1016/S0029-7844(01)01671-4

DO - 10.1016/S0029-7844(01)01671-4

M3 - Article

VL - 99

SP - 248

EP - 254

JO - Obstetrics and Gynecology

JF - Obstetrics and Gynecology

SN - 0029-7844

IS - 2

ER -