Evaluation of inter-observer concordance of the Swede score for digital colposcopic images
DOI:
https://doi.org/10.18597/rcog.3215Keywords:
Colposcopy, uterine cervical neoplasms, cervical cancerAbstract
Objective: To assess inter-observer concordance by training level when applying the Swede score to digital colposcopy images.
Materials and Methods: Concordance study assembled in a cross-sectional study. The population consisted of patients referred for colposcopy to a cervical pathology reference center in Bogotá, Colombia, due to abnormal cytology. Convenience sampling was used. Measured variables were age, level of education, marital status, risk factors for cervical cancer such as parity, age of sexual activity initiation and number of sexual contacts, contraceptive method, cytology report and colposcopy result according to the criteria of the Swede score. Concordance was calculated using the weighted kappa (k) index.
Results: The analysis was based on a set of 3 digital colposcopic images of 251patients. For the total score on the scale, low agreement (k = 0.38; 95% CI: 0.26-0.44) was found between two expert gynecologists; low agreement (k = 0,.7; 95% CI: 0.20-0.38) was also shown for a pair of gynecolo- gists with different training levels, while moder- ate agreement (k = 0.45; 95% CI: 0.34-0.53) was found for the third pair. For individual criteria on the Swede scale, the best agreement was found for “acetowhite reaction” and “lesion size” (k = 0.43; 95% CI: 0.33-0.53).
Conclusions: Inter-observer concordance using the Swede score for digital colposcopic images ranged from low to moderate according to the level of training of the gynecologists.
Author Biographies
Marcos Fidel Castillo-Zamora, Universidad de la Sabana
Médico ginecobstetra. Profesor Asistente Ginecología y Obstetricia, Universidad de la Sabana, Chía - Cundinamarca (Colombia).
Julie Angélica Mora-Enríquez, Universidad de la Sabana
Médica ginecobstetra, Universidad de la Sabana, Chía - Cundinamarca (Colombia). SOGOS, Medellín (Colombia).
Jairo Amaya-Guio, Universidad Nacional de Colombia
Médico ginecobstetra, especialista en Epidemiología. Profesor Titular, Universidad Nacional de Colombia, Subred Norte, Bogotá (Colombia).
Sonia Salamanca-Mora, Universidad Javeriana
Médica ginecobstetra, Universidad Javeriana; colposcopista, GineSalud, Bogotá (Colombia).
Solange Monsalve-Páez, Universidad de la Sabana
Médica ginecobstetra, Universidad de la Sabana, Chía - Cundinamarca (Colombia).
Nicolás Granados-Casallas, Universidad de La Sabana
Estudiante de Medicina, Universidad de La Sabana, Chía – Cundinamarca (Colombia).
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