{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T04:24:09Z","timestamp":1747196649391,"version":"3.40.5"},"reference-count":54,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2024,10,31]],"date-time":"2024-10-31T00:00:00Z","timestamp":1730332800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>Women who receive a result of an abnormal Papanicolaou (Pap) smear can fail to participate in follow up procedures, and this is often due to anxiety. This study aimed to apply artificial neural networks (ANN) in prediction of anxiety in women with an abnormal Pap smear test, prior to and following diagnostic procedures.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>One hundred-seventy two women who received an abnormal Pap screening result took part in this study, completing a questionnaire about socio-demographic characteristics and Hospital Anxiety and Depression Scale (HADS), right before and two to four weeks after diagnostics (i.e. colposcopy\/biopsy\/endocervical curettage). A feedforward back-propagation multilayer perceptron model was applied in analysis.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Prior to diagnostic procedures 50.0% of women experienced anxiety, while after diagnostics anxiety was present in 61.6% of women. The correlation-based feature selection showed that anxiety prior to diagnostic procedures was associated with the use of sedatives, worry score, depression score, and score for concern about health consequences. For anxiety following diagnostics, predictors included rural place of residence, depression score, history of spontaneous abortion, and score for tension and discomfort during colposcopy. The ANN models yielded highly accurate anxiety prediction both prior and after diagnostics, 76.47% and 85.30%, respectively.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The presented findings can aid in identification of those women with a positive Pap screening test who could develop anxiety and thus represent the target group for psychological support, which would consequently improve adherence to follow-up diagnostics and enable timely treatment, finally reducing complications and fatal outcome.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0312870","type":"journal-article","created":{"date-parts":[[2024,10,31]],"date-time":"2024-10-31T17:43:02Z","timestamp":1730396582000},"page":"e0312870","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Detecting the impact of diagnostic procedures in Pap-positive women on anxiety using artificial neural networks"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5347-3264","authenticated-orcid":true,"given":"Irena","family":"Ilic","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Goran","family":"Babic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aleksandra","family":"Dimitrijevic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra Sipetic","family":"Grujicic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vladimir","family":"Jakovljevic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivana Zivanovic","family":"Macuzic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Milena","family":"Ilic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,10,31]]},"reference":[{"issue":"2","key":"pone.0312870.ref001","doi-asserted-by":"crossref","first-page":"e197","DOI":"10.1016\/S2214-109X(22)00501-0","article-title":"Global estimates of incidence and mortality of cervical cancer in 2020: a baseline analysis of the WHO Global Cervical Cancer Elimination Initiative","volume":"11","author":"D Singh","year":"2023","journal-title":"Lancet Glob Health"},{"issue":"3","key":"pone.0312870.ref002","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"H Sung","year":"2021","journal-title":"CA Cancer J Clin"},{"issue":"1","key":"pone.0312870.ref003","first-page":"10","article-title":"Cancer mortality in Serbia, 1991\u20132015: an age-period-cohort and joinpoint regression analysis","volume":"38","author":"M Ilic","year":"2018","journal-title":"Cancer Commun (Lond)"},{"issue":"7","key":"pone.0312870.ref004","doi-asserted-by":"crossref","first-page":"1353","DOI":"10.1016\/j.pec.2017.01.020","article-title":"Predictors of adherence to follow-up recommendations after an abnormal Pap smear among underserved inner-city women","volume":"100","author":"SM Miller","year":"2017","journal-title":"Patient Educ Couns"},{"issue":"1","key":"pone.0312870.ref005","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1186\/s12905-022-02043-y","article-title":"Barriers to uptake of cervical cancer screening services in low-and-middle-income countries: a systematic review","volume":"22","author":"Z Petersen","year":"2022","journal-title":"BMC Womens Health"},{"issue":"16","key":"pone.0312870.ref006","doi-asserted-by":"crossref","first-page":"2114","DOI":"10.1001\/jama.287.16.2114","article-title":"The 2001 Bethesda System: terminology for reporting results of cervical cytology","volume":"287","author":"Forum Group Members; 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