Trial reportBMJ open2014
Evaluation of the accuracy in detecting cervical lesions by nurses versus doctors using a stationary colposcope and Gynocular in a low-resource setting.
Trial report in BMJ open, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 3 syntheses or guidelines pooled it, 37 citations in OpenAlex.
- A systematic review of handheld tools in lieu of colposcopy for cervical neoplasia and female genital schistosomiasis.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2021Pooled it
- Screening test accuracy of portable devices that can be used to perform colposcopy for detecting CIN2+ in low- and middle-income countries: a systematic review and meta-analysis.BMC women's health · 2020Pooled it
- Evaluating the implementation of cervical cancer screening programs in low-resource settings globally: a systematized review.Cancer causes & control : CCC · 2020Pooled it
- Automated Image Clarity Detection for the Improvement of Colposcopy Imaging with Multiple Devices.Biomedical signal processing and control · 2025Article
- Supporting the global reduction of cervical cancer: challenges in colposcopy practice and training.Frontiers in oncology · 2025Review
- Optical imaging for screening and early cancer diagnosis in low-resource settings.Nature reviews bioengineering · 2024Article
- Optical imaging for early detection of cervical cancer: state of the art and perspectives.Journal of biomedical optics · 2023Review
- Diagnostic accuracy of hand-held colposcope (Gynocular) in comparison with standard colposcope in patients with abnormal cervical cytology or visual inspection with acetic acid positivity: a cross over randomized controlled study.Obstetrics & gynecology science · 2023Article
- Development of a multimodal mobile colposcope for real-time cervical cancer detection.Biomedical optics express · 2022Article
- Cervical Imaging in the Low Resource Setting: A Review.Biosensors · 2022Review
- Screening test accuracy to improve detection of precancerous lesions of the cervix in women living with HIV: a study protocol.BMJ open · 2020Article
- An alternative approach for estimating the accuracy of colposcopy in detecting cervical precancer.PloS one · 2015Article
- Evaluating the feasibility of utilizing Gynocular-triage-to-diagnose application with VIA (Visual inspection with Acetic acid) in community cervical cancer screening programs in rural Mysore, India.Indian journal of cancerArticle
- Misleading at Best: A Critical Appraisal of "Nurse-Physician Substitution in Hospital Settings".Missouri medicineArticle
Corrections and comments
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Authors and funding
10 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesEvaluation of the performance of VIA (visual inspection with acetic acid) trained nurses to learn colposcopy and the Swede score method to detect cervical lesions by using stationary colposcope or a portable, hand-held colposcope; the Gynocular, as compared to doctors.
designA crossover randomised clinical trial.
settingThe Colposcopy Clinic of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh.
participants932 women attending the clinic as either screening naïve for VIA screening (404) or women referred as VIA positive (528) from other VIA screening centres in the Dhaka region.
interventionVIA trained nurses were trained on-site in colposcopy and in the Swede score systematic colposcopy method. The Swede score grade cervical acetowhiteness, margins plus surface. vessel pattern, lesion size and iodine staining. The women were randomised to start the examination by either a stationary colposcope or the Gynocular. Swede scores were first obtained by a nurse and the same patient was equally evaluated by a doctor. PRIMARY AND SECONDARY OUTCOME MEASURES: Agreement between nurses and doctors in Swede scores was evaluated using the weighted κ statistic for the Gynocular and standard colposcope. The ability to predict CIN 2+ (CIN 2, CIN 3 and invasive cervical cancer) using Swede scores was evaluated using receiver-operating characteristic curves.
resultsThe Swede scores obtained by nurses and doctors using the Gynocular and stationary colposcope showed high agreement with a κ statistic of 0.858 and 0.859, respectively, and no difference in detecting cervical lesions in biopsy. Biopsy detected CIN 2+ in 39 (4.2%) women.
conclusionsOur study showed that VIA nurses can perform colposcopy. There was no significant differences compared to doctors in detecting cervical lesions by stationary colposcope or the Gynocular using the Swede score system. Swede scores obtained by nurses using the Gynocular could offer an accurate cervical diagnostic approach in low resource settings. TRIAL REGISTRATION NUMBER: ISRCTN53264564.
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