Dataset Information

Office Cervicoscopy versus Stationary Colposcopy in Suspicious Cervix: A Randomized Controlled Trial.

ABSTRACT:

Study objective

The objective of the study was to estimate the diagnostic accuracy and doctor satisfaction of small caliber office cervicoscopy versus stationary colposcopy in diagnosis of ectocervical as well as endocervical lesions in women clinically presented with suspicious cervix.

Patients and methods

Eligible 112 cases with clinically suspicious cervix were randomized into Group A (56 cases) and Group B (56 cases) who were subjected to small caliber office cervicoscopy and stationary colposcopy, respectively. The outcome was the diagnostic accuracy and safety of both tools for detection of ectocervical and endocervical cervical lesions.

Results

There was no statistically significant difference between both groups regarding parity, previous abortion, age at marriage, duration of marriage, and age at menarche and menopause. On unaided naked eye examination of the cervix (UNEE), there were no statistically significant differences between both groups. Diagnostic indices were similar in both groups apart from the finding that office cervicoscopy was more sensitive for detection of endocervical abnormalities. Doctors were significantly more satisfied with stationary colposcopy than office cervicoscopy.

Conclusions

Office cervicoscopy is a good complementary tool added to stationary colposcopy for detection of cervical lesions in cases with suspicious cervix as an example of high-risk group for cervical cancer. Due to its small caliber, cervicoscopy offers a better evaluation of the endocervical canal, especially in cases of Type 2 and 3 transformation zone with a possibility of examination of the endometrial cavity.

SUBMITTER: Darwish AM

PROVIDER: S-EPMC6767956 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:BACKGROUND:Induction of labor (IoL) is an increasingly common obstetric procedure. Foley catheter IoL is recommended by WHO. It is associated with the lowest rate of uterine hyperstimulation syndrome and similar duration to delivery and vaginal delivery rate compared to other methods. Insertion is typically via speculum but digital insertion has been reported to be faster, better tolerated and with similar universal insertion success compared to speculum insertion in a mixed population of nulliparas and multiparas. Transcervical procedure is more challenging in nulliparas and when the cervix is unripe. We evaluated the ease and tolerability of digital compared to speculum insertion of Foley catheter for induction of labor in nulliparas with unripe cervixes. METHODS:A randomized trial was performed in a university hospital in Malaysia. Participants were nulliparas at term with unripe cervixes (Bishop Score???5) admitted for IoL who were randomized to digital or speculum-aided transcervical Foley catheter insertion in lithotomy position. Primary outcomes were insertion duration, pain score [11-point Visual Numerical Rating Scale (VNRS)], and failure. All primary outcomes were recorded after the first insertion. RESULTS:Data from 86 participants were analysed. Insertion duration (with standard deviation) was 2.72?±?1.85 vs. 2.25?±?0.55?min p?=?0.12, pain score (VNRS) median [interquartile range] 3.5 [2-5] vs. 3 [2-5] p?=?0.72 and failure 2/42 (5%) vs. 0/44 (0%) p?=?0.24 for digital vs speculum respectively. There was no significant difference found between the two groups for all three primary outcomes. Induction to delivery 30.7?±?9.4 vs 29.6?±?11.5?h p?=?0.64, Cesarean section 25/60 (64%) vs 28/64 (60%) RR 0.9 95% CI p?=?0.7 and maternal satisfaction VNRS score with the birth process 7 [IQR 6-8] vs 7 [7-8] p?=?0.97 for digital vs. speculum arms respectively. Other labor, delivery and neonatal secondary outcomes were not significantly different. CONCLUSION:Digital and speculum insertion in nulliparas with unripe cervixes had similar insertion performance. As digital insertion required less equipment and consumables, it could be the preferred insertion method for the equally adept and the insertion technique to train towards. TRIAL REGISTRATION:This trial was registered with ISRCTN registration number 13804902 on 15 November 2017.

Project description:BackgroundDecreases in smoking prevalence from recent decades have slowed, and national goals to reduce tobacco use remain unmet. Healthcare providers, including those in physician and dental teams, have access to evidence-based guidelines to help patients quit smoking. Translation of those guidelines into practice, however, remains low. Approaches that involve screening for drug use, brief intervention, and referral to treatment (SBIRT) are a promising, practical solution.PurposeThis study examined whether dentists and dental hygienists would assess interest in quitting, deliver a brief tobacco intervention, and refer to a tobacco quitline more frequently as reported by patients if given computer-assisted guidance in an electronic patient record versus a control group providing usual care.DesignA blocked, group-randomized trial was conducted from November 2010 to April 2011. Randomization was conducted at the clinic level. Patients nested within clinics represented the lowest-level unit of observation.Setting/participantsParticipants were patients in HealthPartners dental clinics.InterventionIntervention clinics were given a computer-assisted tool that suggested scripts for patient discussions. Usual care clinics provided care without the tool.Main outcome measuresPrimary outcomes were post-appointment patient reports of the provider assessing interest in quitting, delivering a brief intervention, and referring them to a quitline.ResultsPatient telephone surveys (72% response rate) indicated that providers assessed interest in quitting (control 70% vs intervention 87%, p=0.0006); discussed specific strategies for quitting (control 26% vs intervention 47%, p=0.003); and referred the patient to a tobacco quitline (control 17% vs intervention 37%, p=0.007) more frequently with the support of a computer-assisted tool integrated into the electronic health record.ConclusionsClinical decision support embedded in electronic health records can effectively help providers deliver tobacco interventions. These results build on evidence in medical settings supporting this approach to improve provider-delivered tobacco cessation.Trial registrationThis study is registered at ClinicalTrials.govNCT01584882.