Postgraduate Training Course in Reproductive Health/Chronic Disease
Table 1 : Description of Studies Reviewed
| Authors/ Year (Reference) |
Type of study | Purpose | No of women screened | Setting | Technique | Intervention (VIA) done by | Independence of assessments | Key Statistics | Reference Standard | Comments |
| Megevand et al 1996 (20) | Cross sectional | VIA as an alternative to cytology | 2426 | Community-based (Mobile clinics in a squatter area in Cape Town, South Africa) | described | Trained Nurses, Community Health workers | Cytotechnologist not blinded to result | Positive Predictive Value | Colposcopy with or without a biopsy | Cytotechnologist not blinded to study results, limited by lack of information on those patients negative on VIA and cytology |
| Sankaranarayanan et al 1998 (21) | Cross sectional | Compare performance of VIA and cytology | 3000 | Community-based (Open access cancer detection clinics in Karala, India) | described | Trained cytotechnologists | blinded | Sensitivity ratio, approximate sensitivity, approximate specificity | Colposcopy with or without a biopsy | Reference test not applied to women who were screening test negative |
| Sankanarayanan et al 1999 (22) | Cross sectional | Compare performance of VIA and cytology | 1351 | Community-based (In Ernakulam, India) | described | Trained nurses | blinded | Sensitivity ratio, approximate sensitivity, approximate specificity | Colposcopy with or without a biopsy | Reference test not applied to women who were screening test negative |
| University of Zimbabwe/ JHPIEGO 1999 (26) | Cross sectional | Test qualities of VIA | 10934 phase 1-8731 phase 2-2203 |
Community-based (151 clinics Chitungwiza and Greater Harare Area, Zimbabwe) | described | Trained nurse-midwife | blinded | Sensitivity/Specificity | Colposcopy with or without a biopsy | Phase 1- work up vias, Phase 2- all women underwent gold standard |
| Denny et al 2000 (23) | Cross sectional | Compare performance of cytology, VIA, VIA with magnification and HPV DNA in detecting HGSIL | 2944 | Community based (clinics in Khagelitska, South Africa) | described | Trained nurses | blinded | Sensitivity ratio, approximate sensitivity, approximate specificity | Colposcopy with or without a biopsy | Reference standard not applied to the women who were screening test negative |
| Cronje et al 2000 (27) | Cross sectional | Compare cytology, cervicography, VIA | 6301 | Community based (Volunteers throughout Free State Province of South Africa) | described | Trained Nurses | blinded | Sensitivity, Specificity, Positive Predictive Value, Negative Predictive Value | Colposcopy with biopsy | Gold standard done on all women |
| Belinson , Quia et al 2001 (28) | Cross-sectional | Determine accuracy of 6 screening tests: conventional cytology, liquid based cytology, VIA, colposcopy, HPV testing, fluorescence spectroscopy | 1997 | Community-based (Rural Shanxi Province, China) | described | Gynaecologic Oncologists | blinded | Sensitivity, Specificity, Positive Predictive Value, Negative Predictive Value | Colposcopy with biopsy | Gold standard done on all women Result may not be reproducible VIA performed by Gynaecologic Oncologists |
| Ngelangel et al 2001 (29) | Cross sectional | VIA alone, VIA with magnification compared to cytology | 13,710 | Hospital based (6 Metro Manila Hospitals and 6 regional Hospitals Philippines) | described | Tained nurses, midwives, physicians from community centres | blinded | Sensitivity, Specificity, Positive Predictive Value, Negative Predictive Value | Colposcopy with or without a biopsy | Reference standard used was colposcopy not applied to the women who were screening test negative |
| Denny et al 2002 (24) | Cross Sectional | Compare VIA and VIA with magnification to cytology | 2754 | Community based (Periurban settlement in Cape Town, South Africa) | described | Trained Nurses | blinded | Sensitivity ratio, approximate sensitivity, approximate specificity | Colposcopy with or without a biopsy | Reference standard not applied to the women who were screening test negative |