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Obstetrics and gynaecology
Original research
Added value of electrical impedance spectroscopy in adjunction of colposcopy: a prospective cohort study
  1. Laura Bergqvist1,
  2. Annu Heinonen1,
  3. Xavier Carcopino2,
  4. Charles Redman3,
  5. Karoliina Aro1,
  6. Mari Kiviharju1,
  7. Seppo Virtanen1,
  8. Pirjo-Liisa Omar1,
  9. Laura Kotaniemi-Talonen4,5,
  10. Karolina Louvanto4,5,
  11. Pekka Nieminen1,
  12. Ilkka Kalliala1,6
  1. 1Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
  2. 2Department of Obstetrics and Gynaecology, APHM, AMU, Marseille, France
  3. 3Department of Obstetrics and Gynaecology, University Hospital of North Midlands, Stoke-on-Trent, UK
  4. 4Department of Obstetrics and Gynaecology, Tampere University Hospital, Tampere, Finland
  5. 5Department of Obstetrics and Gynaecology, Faculty of Medecine and Health Technology, Tampere University, Tampere, Finland
  6. 6Department of Metabolism, Digestion and Reproduction and Department of Surgery and Cancer, Institute of Reproductive and Developmental Biology, Faculty of Medecine, Imperial College, London, UK
  1. Correspondence to Dr Laura Bergqvist; laura.bergqvist{at}hus.fi

Abstract

Objective To assess whether electrical impedance spectroscopy (EIS) as an adjunctive technology enhances the performance of colposcopy.

Design Prospective cohort study.

Setting University Hospital colposcopy clinic.

Participants Colposcopy with EIS for 647 women and conventional colposcopy for 962 women.

Interventions Comparison of the performance of colposcopy by referral cervical cytology in two cohorts, with and without EIS as an adjunctive technology.

Outcome measures Prevalence of cervical intraepithelial neoplasia grade 2 or worse (CIN2+), diagnostic testing accuracy to detect CIN2+ with and without EIS and their relative differences between cohorts.

Results The prevalence of CIN2+ varied between the cohorts according to referral cytology: 17.0% after abnormal squamous cells of unknown significance referral cytology in EIS cohort and 9.1% in the reference cohort, 16.5% and 18.9% after low-grade squamous intraepithelial lesion (LSIL), 44.3% and 58.2% after atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (HSIL) (atypical squamous cells that cannot exclude HSIL), and 81.9% and 77.0% after HSIL cytology, respectively. Sensitivity to detect CIN2+ was higher in the EIS cohort, varying from 1.79 (95% CI 1.30 to 2.45) after LSIL referral cytology to 1.16 (95% CI 1.09 to 1.23) after HSIL referral cytology, with correspondingly lower specificity after any referral cytology.

Conclusions Colposcopy with EIS had overall higher sensitivity but lower specificity to detect CIN2+ than conventional colposcopy. CIN2+ prevalence rates were, however, not consistently higher in the EIS cohort, suggesting innate differences between the cohorts or truly lower detection rates of CIN2+ for EIS, highlighting the need for randomised controlled trials on the effectiveness of EIS.

  • colposcopy
  • gynaecological oncology
  • community gynaecology

Data availability statement

Data are available upon reasonable request.

https://creativecommons.org/licenses/by/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

https://doi.org/10.1136/bmjopen-2023-074921

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    Data availability statement

    Data are available upon reasonable request.

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    Footnotes

    • PN and IK contributed equally.

    • Contributors PN acts as guarantor and accepts full responsibility for the work and/or the conduct of the study, had access to the data, and controlled the decision to publish.

      PN and IK were responsible for the conceptualisation and design of the study as well as methodology. XC, KL and LK-T contributed to conceptualisation. LB performed the statistical analysis with the aid of IK. LB, PN, MK, P-LO, SV and AH were responsible for data collection. LB drafted the original manuscript and IK, PN, CR, XC, KL, LK-T, AH and KA participated in writing, reviewing and editing. All authors listed qualify for authorship and approved the final version of the paper.

    • Funding Open access funded by Helsinki University Library. Finnish State Research Funding, Academy of Finland and Suomen lääketieteen säätiö are funding this manuscript.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.