Application of a diagnosis flow draft based on appearance impression for detection of vulvar disease
Author:
Zhou Qi1, Chen Fang1, Wang Yan1, Qu Wenjie1, Gong Yingxin1, Cao Yuankui1, Zhang Hongwei1, Wang Qing1, Chen Limei1, Cong Qing1, Lin Lin1, Mo Jiayin1, Bi Tianyi1, Ding Jingxin1, Sui Long1, Li Yanyun1
Affiliation:
1. Obstetrics and Gynecology Hospital of Fudan University , Shanghai , China
Abstract
Abstract
Objectives
The aims of this retrospective study were to evaluate the clinical applicability of the latest International Society for the Study of Vulvovaginal Disease (ISSVD) and International Federation for Cervical Pathology and Colposcopy (IFCPC) terminology for vulvar diseases, and to explore a new evaluation flow to optimize decision-making on diagnosis.
Methods
1,068 patients with 5,340 qualified vulvar images were evaluated by observers using 2011 ISSVD and 2011 IFCPC terminology systems. The sensitivity, specificity, positive predictive value, negative predictive value, Youden Index and Overall Diagnostic Value (ODV) were calculated for each finding in the two systems. Then the disease diagnosis order and a diagnosis flow draft (DFD) were obtained.
Results
A total of 15 kinds of vulvar diseases were diagnosed. The proportion of patients accompanied with cervical or vaginal intraepithelial neoplasia was highest (83.3 %) in vulvar Paget’s disease group (p<0.001). Total area of lesions was larger in vulvar Paget’s disease, lichen simplex chronicus and lichen sclerosus group (p<0.001). Among the top five findings of ODV, some findings inferred several (≥6) kinds of diseases, while some findings only exist in a certain disease. When the DFD was used, the agreement between the initial impression and histopathology diagnosis was 68.8 %, higher than those when ISSVD an IFCPC terminology systems used (p=0.028), and it didn’t change with the experience of the observer (p=0.178).
Conclusions
Based on the findings in ISSVD and IFCPC terminology systems, we explored a DFD for observers with different experience on the detection of vulvar disease.
Funder
Shanghai Nature Science Foundation Science and Technology Commission of Shanghai Municipality National Natural Science Foundation of China
Publisher
Walter de Gruyter GmbH
Subject
Biochemistry (medical),Clinical Biochemistry,Public Health, Environmental and Occupational Health,Health Policy,Medicine (miscellaneous)
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