Postgraduate Training Course in Reproductive Health/Chronic Disease
Table 2 : Data from Studies Reviewed (VIA)
| Authors/ Year (Reference) | No of women screened | Age range | Key results (Sensitivity, Specificity, PPV, NPV when available) | Reference Standard | Comments | |
| 1 | Megevand et al 1996 (20) | 2426 | 20-83 | Sensitivity of VIA 65% vs 100% for cytology Specificity 97% vs 89% for cytology PPV 72.4% vs 88.9% for cytology |
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 |
| 2 | Sankaranarayanan et al 1998 (21) | 3000 | 25-70 | Sensitivity ratio to cytology= 1.05, p=0.25 Estimated Sensitivity 90% for VIA vs 86% for cytology Estimated specificity 92% for VIA vs 91% for cytology PPV 17.0% vs 17.2% NPV 99% vs 99% |
Colposcopy with or without a biopsy | Reference test not applied to women who were screening test negative |
| 3 | Sankanarayanan et al 1999 (22) | 1351 | 22-70 | Sensitivity ratio to cytology= 1.54, p<0.001 Estimated Sensitivity 96% for VIA vs 62% for cytology Estimated specificity 68% for VIA vs 90% for cytology PPV 15% vs 25% NPV 99% vs 97% |
Colposcopy with or without a biopsy | Reference test not applied to women who were screening test negative |
| 4 | University of Zimbabwe/ JHPIEGO 1999 (26) | 10934 phase 1-8731 phase 2-2203 |
25-55 | Sensitivity of VIA 77% vs 44% for cytology Specificity 64% vs 91% for cytology PPV 19% vs 33% NPV 96% vs 94% |
Colposcopy with or without a biopsy | Phase 1- work up bias, Phase 2- all women underwent gold standard |
| 5 | Denny et al 2000 (23) | 2944 | 35-65 | Sensitivity ratio to cytology= 0.85, p=0.16 Estimated Sensitivity 67% for VIA vs 78% for cytology Estimated specificity 83% for VIA vs 94% for cytology PPV 11% vs 27% NPV 99% vs 99% |
Colposcopy with or without a biopsy | Reference standard not applied to the women who were screening test negative |
| 6 | Cronje et al2000 (27) | 6301 | Ave age 34.4 | Sensitivity 49.4% for VIA vs 19.3% for cytology specificity 48.5% for VIA vs 99.3% for cytology PPV 18.9% vs 86.8% NPV 99% vs 97% |
Colposcopy with biopsy | Reference standard done on all women |
| 7 | Belinson , Quia et al 2001 (28) | 1997 | 35-45 | Sensitivity 71 for VIA % vs 77% for cytology Specificity 74% vs 98% for cytology PPV 11% vs 61% for cytology NPV 98% vs 98% for cytology |
Colposcopy with biopsy | Reference standard done on all women Result may not be reproducible VIA performed by Gynaecologic Oncologists |
| 8 | Ngelangel et al 2001 (29) | 13,710 | 20-65 | Estimated Sensitivity 50.3% for VIA vs 8.5% for cytology Estimated specificity 94.1% for VIA vs 97.3% for cytology |
Colposcopy with or without a biopsy | Reference standard used was colposcopy not applied to the women who were screening test negative |
| 9 | Denny et al 2002 (24) | 2754 | 35-65 | Sensitivity 69.8% for VIA vs 57.4% for cytology specificity 79.3 % for VIA vs 96.3% for cytology PPV 12.9% vs 34.5% NPV 96.3% vs 95.8% |
Colposcopy with or without a biopsy | Reference standard not applied to the women who were screening test negative |