Histological correlation between smartphone and coloposcopic findings in patients with abnormal cervical cytology: experiences in a tertiary referral hospital

Abstract Background Smartphones have recently been applied in the medical setting. However, the literature evaluating the utility of smartphones in gynecologic oncology is limited. Objectives The objectives of the current study were to evaluate the utility of a smartphone in the detection of uterine cervical lesions in patients with abnormal cervical cytology. Study design Seventy-five women with abnormal cervical cytology were enrolled. Two doctors independently inspected the uterine cervix by using smartphone or colposcopy. Images were captured using acetic acid and biopsies were taken as standard-of-care procedures. The diagnostic performance of the smartphone for CIN1 or worse (CIN1+) and CIN2 or worse (CIN2+) were evaluated and the kappa value was calculated to determine the chance corrected agreement of the histological diagnoses based on the smartphone and colposcopic findings. Results There was a substantial agreement between histological diagnoses based on the smartphone and colposcopic findings, with a kappa value of 0.67 [95% CI: 0.43-0.90]. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the smartphone in the diagnosis of CIN1+ were 0.89 [95% confidence interval (CI): 0.79-0.96], 0.33 [95% CI: 0.08-0.70], 0.91 [95% CI: 0.81-0.97], and 0.30 [95% CI: 0.07-0.65], respectively. The sensitivity, specificity, PPV, and NPV in the diagnosis of CIN2+ were 0.92 [95% CI: 0.81-0.98], 0.24 [95% CI: 0.09-0.45], 0.71 [95% CI: 0.58-0.81], and 0.60 [95% CI: 0.26-0.88], respectively. Conclusion We found that there was a substantial agreement between the histological diagnoses based on the smartphone and colposcopic findings. The smartphone seems to be useful and may be an alternative to colposcopy.