Deep learning based cervical screening by the cross-modal integration of colposcopy, cytology, and HPV test

2021 ◽  
pp. 104675
Author(s):  
Le Fu ◽  
Wei Xia ◽  
Wei Shi ◽  
Guang-xu Cao ◽  
Ye-tian Ruan ◽  
...  
Keyword(s):  
Deep Learning ◽  
Cervical Screening ◽  
Hpv Test ◽  
The Cross

scholarly journals Clinical Validation of the cobas 4800 HPV Test for Cervical Screening Purposes

2011 ◽  
Vol 49 (11) ◽  
pp. 3983-3985 ◽  
Author(s):  
D. A. M. Heideman ◽  
A. T. Hesselink ◽  
J. Berkhof ◽  
F. van Kemenade ◽  
W. J. G. Melchers ◽  
...  
Keyword(s):  
Cervical Screening ◽  
Clinical Validation ◽  
Hpv Test

Οικονομική αξιολόγηση της δοκιμασίας HPV DNA ως πρωταρχικής μεθόδου προσυμπτωματικού ελέγχου για καρκίνο τραχήλου της μήτρας στην Ελλάδα

2021 ◽  
Author(s):  
Αναστάσιος Σκρουμπέλος
Keyword(s):  
Purchasing Power Parity ◽  
Price Index ◽  
Cervical Screening ◽  
Consumer Price Index ◽  
Real Life ◽  
Sensitivity Analyses ◽  
Purchasing Power ◽  
Power Parity ◽  
Hpv Dna ◽  
Hpv Test

Ο καρκίνος του τραχήλου της μήτρας αποτελεί την 7η συχνότερη μορφή καρκίνου στις γυναίκες στην Ελλάδα. Η αποτελεσματική διαχείριση της νόσου βασίζεται στην πρόληψη και δει στον προσυμπτωματικό έλεγχο ο οποίος έως πρόσφατα βασιζόταν στην κυτταρολογική εξέταση. Η σύνδεση του καρκίνου του τραχήλου της μήτρας με τον ιό των ανθρωπίνων θηλωμάτων οδήγησε στην ανάπτυξη της δοκιμασίας HPV DNA, η κλινική αποτελεσματικότητα της οποίας αποδεικνύεται πως υπερέχει της καθιερωμένης πρακτικής της κυτταρολογικής εξέτασης. Παρά την κλινική του υπεροχή η εισαγωγή του σε εθνικά προγράμματα προσυμπτωματικού ελέγχου απαιτεί τον έλεγχο της οικονομικής του αποδοτικότητα καθώς υπό τον περιορισμό των σπανίων πόρων η χρηματοδότησή του οφείλει να μεγιστοποιεί την αξία της επένδυσης. Στο πλαίσιο αυτό, σκοπό της παρούσας διατριβής αποτελεί η διερεύνηση της οικονομικής αποδοτικότητας εναλλακτικών στρατηγικών προσυμπτωματικού. Η προσέγγιση της υπόθεσης εργασίας επιτευχθεί με την ανάπτυξη μαρκοβιανών υποδειγμάτων τα οποία εξέτασαν την αποτελεσματικότητα και το κόστος εννέα εναλλακτικών στρατηγικών προσυμπτωματικού ελέγχου στην Ελλάδα. Οι στρατηγικές ελέγχθηκαν με ενναλακτικές προσεγγίσεις των βασικών παραμέτρων τους όπως η πρωταρχική μέθοδος, το διάστημα επανελέγχου, τα ηλικιακά όρια του πληθυσμού-στόχου και το επίπεδο συμμόρφωσης. Οι αναλύσεις διεξήχθησαν υπό την οπτική του συστήματος υγείας και βασίστηκαν ως επί το πλείστων στην κλινική μελέτη HERMES (HEllenic Real life Multicentric cErvical Screening), για τις κλινικές και επιδημιολογικές παραμέτρους των υποδειγμάτων και σε δεδομένα της κοινωνικής ασφάλισης για τις τιμές των παρεμβάσεων υγείας και των ιατρικών πράξεων. Δεδομένης της απουσίας δεδομένων σχετικά με το κόστος διαχείρισης της νόσου χρησιμοποιήθηκαν ευρωπαϊκά δεδομένα τα οποία μετατράπηκαν σε ελληνικές σχετικές τιμές με την χρήση των Δεικτών Τιμών Καταναλωτή (Consumer Price Index, CPI) ιατροτεχνολογικών υπηρεσιών και προϊόντων και των δεικτών Ισοτιμίας Αγοραστικής Δύναμης (Purchasing Power Parity, PPP). Τέλος, για τον έλεγχο της αξιοπιστίας των αποτελεσμάτων διεξήχθη μια σειρά από ντερμινιστικές (one way sensitivity analyses) και πιθανολογικές αναλύσεις ευαισθησίας (probabilistic sensitivity analyses). Η αποτελεσματικότητα των στρατηγικών προέκυψε ότι μεγιστοποιείται με τις 4 στρατηγικές (HPV test ταυτόχρονη γονοτύπηση, HPV test μετέπειτα γονοτύπηση, συνδυασμός κυτταρολογικής εξέτασης & HPV test μετέπειτα γονοτύπηση, συνδυασμός κυτταρολογικής εξέτασης & HPV test ταυτόχρονη γονοτύπηση,) οι οποίες προσφέρουν HPV test με γονοτύπηση ανά 3 έτη και απευθύνονται σε γυναίκες 25-69 με πλήρη συμμόρφωση στον έλεγχο (100%). Οι στρατηγικές αυτές δύνανται να μειώσουν την επίπτωση της νόσου σε γυναίκες 25-85 ετών κατά 24,5% σε σχέση με την τρέχουσα πρακτική (7,64 περιστατικά/100.000 γυναίκες, 95% CI 7,56 – 7,69 έναντι 10,12, 95% CI 9,99 – 10,26) και κατά 34,9% σε σχέση με της χαμηλότερης αποτελεσματικότητας στρατηγικής HPV test χωρίς γονοτύπηση ανά 5 έτη (11,47, 95% CI 11,30 – 11,61). Ο λόγος κόστους-χρησιμότητας της στρατηγικής με HPV test και ταυτόχρονη γονοτύπηση ανά 3 ή 5 έτη σε σχέση με την τρέχουσα πρακτική εκτιμήθηκε στα 3.918€/QALY και στα –162.843€/QALY, αντίστοιχα, αρκετά χαμηλότερα από το συμβατικό όριο των 52.437€/QALY. Η υιοθέτηση ενός προγράμματος προσυμπτωματικού ελέγχου με HPV test και ταυτόχρονη γονοτύπηση ανά 3 ή 5 έτη για γυναίκες 25-69 ετών αποτελεί μια οικονομικά αποδοτική επιλογή η οποία βελτιώνει τις εκβάσεις υγείας των γυναικών και βελτιστοποιεί την κατανομή των πόρων που επενδύονται στην πρόληψη του καρκίνου του τραχήλου της μήτρας στην Ελλάδα.

scholarly journals Validation of a Human Papillomavirus (HPV) DNA Cervical Screening Test That Provides Expanded HPV Typing

2018 ◽  
Vol 56 (5) ◽  
Author(s):  
Maria Demarco ◽  
Olivia Carter-Pokras ◽  
Noorie Hyun ◽  
Philip E. Castle ◽  
Xin He ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Excellent Agreement ◽  
Cervical Screening ◽  
Weighted Kappa ◽  
Clinical Value ◽  
Becton Dickinson ◽  
Major Question ◽  
Dna Test ◽  
Hpv Dna ◽  
Hpv Test

ABSTRACT As cervical cancer screening shifts from cytology to human papillomavirus (HPV) testing, a major question is the clinical value of identifying individual HPV types. We aimed to validate Onclarity (Becton Dickinson Diagnostics, Sparks, MD), a nine-channel HPV test recently approved by the FDA, by assessing (i) the association of Onclarity types/channels with precancer/cancer; (ii) HPV type/channel agreement between the results of Onclarity and cobas (Roche Molecular Systems, Pleasanton, CA), another FDA-approved test; and (iii) Onclarity typing for all types/channels compared to typing results from a research assay (linear array [LA]; Roche). We compared Onclarity to histopathology, cobas, and LA. We tested a stratified random sample ( n = 9,701) of discarded routine clinical specimens that had tested positive by Hybrid Capture 2 (HC2; Qiagen, Germantown, MD). A subset had already been tested by cobas and LA ( n = 1,965). Cervical histopathology was ascertained from electronic health records. Hierarchical Onclarity channels showed a significant linear association with histological severity. Onclarity and cobas had excellent agreement on partial typing of HPV16, HPV18, and the other 12 types as a pool (sample-weighted kappa value of 0.83); cobas was slightly more sensitive for HPV18 and slightly less sensitive for the pooled high-risk types. Typing by Onclarity showed excellent agreement with types and groups of types identified by LA (kappa values from 0.80 for HPV39/68/35 to 0.97 for HPV16). Onclarity typing results corresponded well to histopathology and to an already validated HPV DNA test and could provide additional clinical typing if such discrimination is determined to be clinically desirable.

Levels of anxiety and distress following receipt of positive screening tests in Australia’s HPV-based cervical screening programme: a cross-sectional survey

2020 ◽  
Vol 96 (3) ◽  
pp. 166-172 ◽  
Author(s):  
Rachael Helen Dodd ◽  
Olivia Mac ◽  
Julia M L Brotherton ◽  
Erin Cvejic ◽  
Kirsten J McCaffery
Keyword(s):  
Online Survey ◽  
Screening Program ◽  
Cervical Screening ◽  
Screening Tests ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
General Distress ◽  
Hpv Test ◽  
Hpv Screening ◽  
Test Result

ObjectiveFrom December 2017, the Australian National Cervical Screening Program commenced 5 yearly primary human papillomavirus (HPV) screening; one of the first high-income countries to implement primary HPV screening. This study aimed to examine the psychosocial impact of self-reporting testing HPV positive in a sample of women screened since the renewal of the programme.MethodsWomen in Australia aged 25–74 years who reported participating in cervical screening since December 2017 were recruited through an online market research company to complete a cross-sectional survey. The primary outcomes were anxiety and general distress.Results1004 women completed the online survey; 80.9% reported testing HPV negative (HPV−), 6.5% reported testing HPV positive (HPV+) and 12.9% did not know/remember their test result. Women who reported testing HPV+ had significantly poorer psychological outcomes on a range of measures. Those who reported testing HPV+ had higher anxiety scores (53.03 vs 43.58 out of 80, p<0.001), showed more general distress (3.94 vs 2.52 out of 12, p=0.004), concern about their test result (5.02 vs 2.37, p<0.001), expressed greater distress about their test result (7.06 vs 4.74, p<0.001) and cancer worry (quite or very worried 35.4% vs 11.6%, p<0.001) than women who reported testing HPV−. Concern regarding test results was also significantly higher in women who did not know/remember their test result (3.20 vs 2.37, p<0.001) compared with women who reported testing HPV−. Women who reported testing HPV+ had greater knowledge of HPV (9.25 vs 6.62, p<0.001) and HPV testing (2.44 vs 1.30, p<0.001) than women who reported testing HPV−.ConclusionsReceipt of an HPV+ test result was associated with high levels of anxiety and distress, which reached clinical significance. Further work is needed to understand whether distress and concern could be reduced by ensuring all women receive high-quality standardised information with their results or by other interventions.

scholarly journals Raman Spectroscopy of Liquid-Based Cervical Smear Samples as a Triage to Stratify Women Who Are HPV-Positive on Screening

Cancers ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 2008
Author(s):  
Damien Traynor ◽  
Cara M. Martin ◽  
Christine White ◽  
Stephen Reynolds ◽  
Tom D’Arcy ◽  
...  
Keyword(s):  
Raman Spectroscopy ◽  
Cervical Screening ◽  
Hpv Infection ◽  
Classification Model ◽  
Cell Nuclei ◽  
Hpv Dna ◽  
Hpv Dna Testing ◽  
Large Numbers ◽  
Hpv Test ◽  
Triage Test

The role of persistent high-risk human papillomavirus (HPV) infection in the development of cervical precancer and cancer is now well accepted, and HPV testing has recently been introduced for primary cervical screening. However, the low specificity of HPV DNA testing can result in large numbers of women with an HPV-positive result, and additional triage approaches are needed to avoid over-referral to colposcopy and overtreatment. The aim of this study was to assess Raman spectroscopy as a potential triage test to discriminate between transient and persistent HPV infection. HPV DNA status and mRNA status were confirmed in ThinPrep® cervical samples (n = 60) using the Cobas 4800 and APTIMA HPV test, respectively. Raman spectra were recorded from single-cell nuclei and subjected to partial least squares discriminant analysis (PLSDA). In addition, the PLSDA classification model was validated using a blinded independent test set (n = 14). Sensitivity of 85% and specificity of 92% were achieved for the classification of transient and persistent HPV infection, and this increased to 90% sensitivity and 100% specificity when mean sample spectra were used instead of individual cellular spectra. This study showed that Raman spectroscopy has potential as a triage test for HPV-positive women to identify persistent HPV infection.

scholarly journals A Review Paper on Deep Learning Approach for Crop Yield Prediction Assessment

2021 ◽  
Vol 7 (05) ◽  
pp. 127-132
Author(s):  
Richa Verma & Ayushi
Keyword(s):  
Deep Learning ◽  
Crop Yield ◽  
Review Paper ◽  
Learning Approach ◽  
Yield Prediction ◽  
Learning Methods ◽  
Remote Sensor ◽  
The Cross ◽  
Precise Assessment

Precise assessment of harvest yield is a difficult field of work. The equipment and programming stage to foresee the harvest yield relies on different components like climate, soil fruitfulness, genotype, and different collaborating wards. The assignment is unpredictable inferable from the information that should be gathered in volumes to comprehend crop yield through remote sensor organizations and distant detecting. This paper audits the previous 15 years of exploration work in the improvement of assessing crop yield utilizing profound learning calculations. The meaning of examining progressions utilizing profound learning methods will help in dynamic for foreseeing the harvest yield. The cross breed mix of profound learning with distant detecting and remote sensor organizations can give accuracy agribusiness later on.

scholarly journals Supervised deep learning embeddings for the prediction of cervical cancer diagnosis

2018 ◽  
Vol 4 ◽  
pp. e154 ◽  
Author(s):  
Kelwin Fernandes ◽  
Davide Chicco ◽  
Jaime S. Cardoso ◽  
Jessica Fernandes
Keyword(s):  
Cervical Cancer ◽  
Deep Learning ◽  
Dimensional Space ◽  
Cervical Screening ◽  
Area Under The Curve ◽  
Clinical Findings ◽  
Screening Programs ◽  
Efficient Access ◽  
Low Dimensional

Cervical cancer remains a significant cause of mortality all around the world, even if it can be prevented and cured by removing affected tissues in early stages. Providing universal and efficient access to cervical screening programs is a challenge that requires identifying vulnerable individuals in the population, among other steps. In this work, we present a computationally automated strategy for predicting the outcome of the patient biopsy, given risk patterns from individual medical records. We propose a machine learning technique that allows a joint and fully supervised optimization of dimensionality reduction and classification models. We also build a model able to highlight relevant properties in the low dimensional space, to ease the classification of patients. We instantiated the proposed approach with deep learning architectures, and achieved accurate prediction results (top area under the curve AUC = 0.6875) which outperform previously developed methods, such as denoising autoencoders. Additionally, we explored some clinical findings from the embedding spaces, and we validated them through the medical literature, making them reliable for physicians and biomedical researchers.

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