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Knowledge assessment test & invitation to participate in a study aiming to improve VIA/VILI criteria for the diagnosis of precancer

How to perform the “Comprehensive Visual Inspection of the Cervix with Acetic Acid (VIA) and Lugol’s Iodine (VILI)” knowledge assessment test?

The test consists of 100 multiple-choice questions (MCQ) requiring you to identify one correct answer from a set of 3 options. You will have a range of clinical cases of HPV-positive women aged between 30 and 50, corresponding to real life screening conditions in terms of CIN2+ prevalence (expected rate 8-15%). These cases include: normal cervix, cervical intraepithelial neoplasia grade 1, 2 or 3 (CIN1, CIN2, CIN3) and cancers.

What is the pass mark of this test?

The pass mark required for the "Comprehensive Visual Inspection of the Cervix with Acetic Acid (VIA) and Lugol’s Iodine (VILI)" knowledge assessment test is 75 out of 100 (75% correct answers). Successful candidates will receive a signed certificate by University Hospitals of Geneva and Geneva Foundation for Medical Education and Research. Unsuccessful candidates can repeat the test, though we suggest allowing sufficient time for additional study.

About the test

All participants have given signed inform consent that digital picture can be used in teaching and research purpose. All are HPV-positive, aged between 30-50 years old, not previously screen and had an endocervical curettage, cervical biopsy (abnormal area or random if normal) and Smartphone picture as routine workload and quality control. A disease is defined as the presence of histologically CIN2+ requiring treatment. Concerning the CIN 1 lesion both treating and not treating them were accepted as correct answers.

Invitation to participate in the improvement of the VIA/VILI criteria

Why should standard VIA/VILI criteria be improved for the triage of HPV-positive women?

Studies support that VIA/VILI approach used as a triage for HPV-positive women is associated with a loss of sensitivity, meaning that CIN2+ detected by HPV test are interpreted as VIA/VILI normal. In order to reduce the false negative rate we have developed the “ABC criteria”.

What are the ABC criteria?

The proposed ABC criteria aims to be a reliable mean to enhance the sensitivity of VIA/VILI approach thus improving the detection of CIN2+ lesions among HPV positive women by concentrating the health care providers attention on certain specific points during the VIA/VILI approach. These points are the object of the study and will be revealed upon participation to the study, to avoid possible bias.

Why do we need your contribution?

The ABC criteria have been developed to improve the diagnosis of CIN2+ in HPV-positive women. They may be particularly beneficial because the mnemonic is easily remembered and criteria are easy to use. However, the value of these criteria still needs to be demonstrated, as well as their sensitivity and specificity. Your contribution will allow us to test these criteria in situations that mimic real life scenarios without penalizing any patients.

How to participate?

If you agree to participate, please fill the Google form that you will find in this link. In the days that follow, you will receive an URL and information in which group you have been randomized (“Standard Group” or in the “ABC Group”). Standard group will have to perform the test according to the traditional IARC criteria while ABC Group will receive the ABC criteria before doing the test. At the end of the test, all participants will have access to the ABC criteria. If you do not wish to participate in the study, please fill in the same form and when asked, specify that you do not wish to participate. Participation is entirely voluntary and the non participation to the study will have no impact on your test scores. Once you have completed the test, if you wish to have access to the study protocol, you may contact us and we will gladly mail you a copy.

Thank you very much for giving up your time to help us with our research.

We would also greatly appreciate if you could provide input and feedback on the tests content and ABC criteria. If you have any queries or comments about the questionnaire or the research study, please contact:

Contact person

Manuela Undurraga
E-mail: manuela.undurraga@gfmer.org