Colposcopy quality control by remote review of digitized colposcopic images

Daron G. Ferris, Mark S. Litaker

Research output: Contribution to journalArticlepeer-review

23 Scopus citations


This study was undertaken to estimate the accuracy of colposcopy quality control review of subjects' digitized colposcopic images during the atypical squamous cells of undetermined significance/low-grade squamous intraepithelial lesion triage study (ALTS). After colposcopic examination and the acquisition of 2 digitized cervical images, colposcopists recorded colposcopic diagnoses in a standardized computer database. The images were transferred by modem to colposcopy quality control reviewers for a blinded interpretation, including assessment of image quality. Reviewers' and colposcopists' diagnoses were compared with histologic diagnoses using standard contingency table methods. Colposcopists and reviewers underdiagnosed 16.1% and 25.3% of subjects, and overdiagnosed 44.7% and 19.8% of subjects compared with histology, respectively. The sensitivity and specificity for detecting cervical intraepithelial neoplasia 2 or greater were 35.4% versus 23.2%, P <. 0001, and 89.9% versus 95.0%, P <. 0001, respectively, for colposcopists and reviewers. Colposcopy quality control by review of digitized colposcopic images in clinical trials warrants further evaluation if the accuracy can be improved.

Original languageEnglish (US)
Pages (from-to)1934-1941
Number of pages8
JournalAmerican journal of obstetrics and gynecology
Issue number6
StatePublished - Dec 2004


  • ATLS trial
  • Cervical intraepithelial neoplasia
  • Colposcopy
  • Quality control

ASJC Scopus subject areas

  • Obstetrics and Gynecology


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