{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:41:14Z","timestamp":1787013674908,"version":"build-2736575974"},"reference-count":44,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2017,7,26]],"date-time":"2017-07-26T00:00:00Z","timestamp":1501027200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"COHEAHR Network","award":["603019"],"award-info":[{"award-number":["603019"]}]},{"name":"Seventh Framework Programme of DG Research of the European Commission (Brussels)"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2018,4]]},"abstract":"\n Background<\/jats:title>\n \n Visual inspection of the cervix with acetic acid (\n VIA<\/jats:styled-content>\n ) or with Lugol's iodine (\n VILI<\/jats:styled-content>\n ) have been evaluated for cervical cancer screening in developing countries.\n <\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n \n To assess the diagnostic accuracy and clinical utility of visual methods to detect cervical intraepithelial neoplasia grade\u00a02+ (\n CIN<\/jats:styled-content>\n 2+) using: (1)\n VIA<\/jats:styled-content>\n alone; (2)\n VILI<\/jats:styled-content>\n alone; (3) co\u2010testing; and (4)\n VILI<\/jats:styled-content>\n as a triage test of a positive\n VIA<\/jats:styled-content>\n result.\n <\/jats:p>\n <\/jats:sec>\n \n Search strategy<\/jats:title>\n \n PubMed,\n EMBASE<\/jats:styled-content>\n , and the Cochrane Library were searched up to May\u00a02016.\n <\/jats:p>\n <\/jats:sec>\n \n Selection criteria<\/jats:title>\n \n All reports on the accuracy of\n VIA<\/jats:styled-content>\n and\n VILI<\/jats:styled-content>\n , or combinations of\n VIA<\/jats:styled-content>\n \/\n VILI<\/jats:styled-content>\n , to detect\n CIN<\/jats:styled-content>\n 2+ were identified. Histology and colposcopy when no biopsy was taken were used as the reference standard.\n <\/jats:p>\n <\/jats:sec>\n \n Data collection and analysis<\/jats:title>\n \n Selected studies were scored on methodological quality, and sensitivity and specificity were computed. Clinical utility was assessed from the positive predictive value (\n PPV<\/jats:styled-content>\n ) and the complement of the negative predictive value (\n cNPV<\/jats:styled-content>\n ).\n <\/jats:p>\n <\/jats:sec>\n \n Main results<\/jats:title>\n \n We included 23 studies comprising 101\u00a0273 women. The pooled sensitivity and specificity of\n VILI<\/jats:styled-content>\n was 88 and 86%, respectively.\n VILI<\/jats:styled-content>\n was more sensitive, but not less specific, compared with\n VIA<\/jats:styled-content>\n (relative sensitivity\u00a0=\u00a01.11; 95% confidence interval, 95%\u00a0\n CI<\/jats:styled-content>\n , 1.06\u20131.16; relative specificity\u00a0=\u00a00.98; 95%\u00a0\n CI<\/jats:styled-content>\n 0.95\u20131.01). Co\u2010testing was hardly more sensitive, but significantly less specific, than\n VILI<\/jats:styled-content>\n alone.\n VILI<\/jats:styled-content>\n to triage\n VIA<\/jats:styled-content>\n \u2010\n POSITIVE<\/jats:styled-content>\n women was not less sensitive, but more specific, compared with\n VIA<\/jats:styled-content>\n alone (relative sensitivity\u00a0=\u00a00.98, 95%\u00a0\n CI<\/jats:styled-content>\n 0.96\u20131.01; relative specificity\u00a0=\u00a01.04, 95%\u00a0\n CI<\/jats:styled-content>\n 1.02\u20131.05). The average\n PPV<\/jats:styled-content>\n s were low (range 11\u201316%), whereas the\n cNPV<\/jats:styled-content>\n varied between 0.3% (\n VILI<\/jats:styled-content>\n , co\u2010testing) and 0.6% (triage).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Although imperfect,\n VILI<\/jats:styled-content>\n alone appeared to be the most useful visual screening strategy.\n <\/jats:p>\n <\/jats:sec>\n \n Tweetable abstract<\/jats:title>\n \n VILI<\/jats:styled-content>\n alone seems to be the most useful visual screening test for cervical cancer screening.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/1471-0528.14783","type":"journal-article","created":{"date-parts":[[2017,6,12]],"date-time":"2017-06-12T04:22:45Z","timestamp":1497241365000},"page":"545-553","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":62,"title":["Accuracy of combinations of visual inspection using acetic acid or lugol iodine to detect 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