Evidence map›Paper›PMID 36854076›Full record

Trial reportJCO global oncology2023

Transformation Zone Assessment Using Visual Inspection With Acetic Acid Before and After Thermal Ablation: Implications for Follow-Up.

Christine Balli, Bruno Kenfack, Apollinaire Horo, Jose Jeronimo, Esther Abatsong, Ania Wisniak, Pierre Vassilakos, Patrick Petignat

Open access · goldAbstract readClinical Trial
In one paragraph

Trial report in JCO global oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.9field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 4 countries.

Christine BalliGynecology Division, Department of Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland.ORCID 0000-0001-9261-5763
Bruno KenfackDepartment of Biomedical Sciences, University of Dschang, Dschang District Hospital, Dschang, Cameroon.
Apollinaire HoroUnit of Gynecology and Obstetrics, University Hospital (CHU) of Yopougon, Abidjan, Ivory Coast.
Jose JeronimoDivision of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD.
Esther AbatsongDepartment of Biomedical Sciences, University of Dschang, Dschang District Hospital, Dschang, Cameroon.
Ania WisniakGynecology Division, Department of Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland.ORCID 0000-0002-3942-2134
Pierre VassilakosGynecology Division, Department of Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland.ORCID 0000-0002-0926-4366
Patrick PetignatGynecology Division, Department of Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland.ORCID 0000-0002-6835-533X
University Hospital of Geneva · CHUniversité de Dschang · CMCentre Hospitalier Universitaire de Yopougon · CINational Institutes of Health · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThermal ablation (TA) has become the conventional method for treatment of precancerous cervical lesions in low-resource settings. After TA, both the squamocolumnar junction (SCJ) and the transformation zone (TZ) may be subject to change. Our aim was to evaluate SCJ and TZ variability after TA.

methodsStudy data were collected in a large prospective trial of a cervical cancer screening campaign in Cameroon. For each patient, two sets of cervical photos (native and with acetic acid) were taken before and 6-12 months after TA. The SCJ and TZ were evaluated independently by three observers according to the WHO nomenclature. When discordances were observed between the type of TZ and SCJ selected by each observer, a corrected TZ was established on the basis of the SCJ categorization. Interobserver agreement for TZ interpretation was evaluated using Cohen's kappa coefficient for agreement between two observers and Fleiss' kappa between three observers.

resultsFifty consecutive participants were included in the analysis. Seventy-six percent were interpreted as TZ1-2, and 24% as TZ3 before TA. In 56% of cases, the entire SCJ could not be entirely visualized after TA, thus being recategorized as TZ3. Interobserver agreement was fair for diagnosis before TA (Kappa coefficient, 0.34; 95% CI, 0.27 to 0.45) and moderate for diagnosis after TA (Kappa coefficient, 0.40; 95% CI, 0.30 to 0.50). After TA, 36% progressed from TZ1-2 to TZ3, with a moderate interobserver agreement (Kappa coefficient, 0.44; 95% CI, 0.40 to 0.54).

conclusionWe observed a shift of the SCJ into the endocervical canal after TA. A significant proportion of participants had TZ 3 after treatment, raising the question of visual inspection with acetic acid's applicability as a first-line follow-up examination method after TA.

Indexed as

Acetic AcidUterine Cervical NeoplasmsEarly Detection of CancerFemaleFollow-Up StudiesHumansProspective StudiesAcetic Acid

Identifiers

PMID36854076
PMCPMC10166473
OpenAlexW4322624303

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.