scholarly journals A Study Utilizing Mobile E-Health and Self-Acquired Cervical Screening in Health Clinics

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 213s-213s
Author(s):  
Y.L. Woo ◽  
N.H. Nasir ◽  
J. Kanapathy ◽  
Z. Mohd Said
Keyword(s):  
Mobile Technology ◽  
Screening Test ◽  
Point Of Care ◽  
Cervical Screening ◽  
Pilot Project ◽  
Message Delivery ◽  
Test Results ◽  
Cross Sectional ◽  
Hpv Test ◽  
Hpv Screening

Background: Malaysia continues to have a high incidence of cervical cancer with a relatively high mortality rate due to late presentation. Pilot Project R.O.S.E was a cross-sectional study to assess acceptability, feasibility and reach of a cervical screening strategy that utilizes self-collected, point-of-care HPV testing in primary care settings. Within this study, mobile SMS technology was used to register patients into a cervical screening registry and to deliver the HPV test results. Aim: To assess the feasibility, acceptability, advantages and limitations of the use of mobile SMS technology to deliver HPV screening test results. Methods: Invitation for cervical screening was offered to women aged 30 to 65 years who are presenting to these clinics for care, or accompanying another individual. Upon agreeing to do the test, the nurse registered the woman's details and mobile number. A mobile phone verification SMS is triggered at this point. HPV results were delivered to women via mobile SMS within 3 working days. Phone-based surveys were conducted on randomly selected screened positives and screened negative women to ascertain acceptability of the screening and the usage of mobile technology. Results: Ninety percent of participants received their SMS results without any hitches. Ten percent of participants experienced problems with receiving their results SMS. Further investigations revealed that there were various reasons for message delivery failure. Posttest surveys revealed that majority of participants were satisfied with the use of mobile technology to receive HPV screening test results. Conclusion: This study suggests that the use of mobile SMS technology for delivery of HPV screening test results is feasible and acceptable. However, measures should be taken to overcome technology related failures. The findings of this implementation research may help to inform the design of future mobile SMS technology usage within health settings in Malaysia.

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.

Unpacking the black box: Empirical evidence to understand the human factor for effective rapid testing against SARS-CoV2

2021 ◽  
Author(s):  
Cornelia Betsch ◽  
Philipp Sprengholz ◽  
Regina Siegers ◽  
Sarah Eitze ◽  
Lars Korn ◽  
...  
Keyword(s):  
Social Life ◽  
Point Of Care ◽  
Test Results ◽  
Rapid Testing ◽  
Infection Rates ◽  
Cross Sectional ◽  
Home Tests ◽  
Data Collections ◽  
Willingness To Use ◽  
Test Result

SARS-CoV-2 rapid antigen point-of-care (PoC) and home tests are available to laypeople. This raises questions regarding the drivers and barriers of people’s willingness to use tests, their understanding of test results and the psychological and behavioural consequences of positive and negative test results. Four cross-sectional data collections, including survey items, open text answers and three experiments, were therefore conducted between December 2020 and March 2021, involving 4,026 German participants. The majority was willing to use PoC or home tests. People will be more likely to use tests when they are inexpensive and easy to use or when they are a necessary (given low infection rates) for obtaining access to public and social life. However, people urgently need information about what a test result means and how they should behave. Recommendations based on the present findings could make rapid testing a successful pillar of pandemic management.

scholarly journals Validation of the cobas 6800 human papillomavirus test in primary cervical screening

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0247291
Author(s):  
Karin Sundström ◽  
Helena Lamin ◽  
Joakim Dillner
Keyword(s):  
Human Papillomavirus ◽  
Screening Program ◽  
Cervical Screening ◽  
Relative Sensitivity ◽  
Test System ◽  
P Value ◽  
Histopathological Diagnosis ◽  
Hpv Test ◽  
Relative Specificity ◽  
Hpv Screening

Evaluation of Human Papillomavirus (HPV) testing systems suitable for large-scale organized cervical screening programs is required. We evaluated the cobas 6800 HPV test system for detection of cervical intraepithelial neoplasia grade 3 or worse (CIN3+) when nested in an organized primary HPV screening program, using the cobas 4800 test as comparator. The Karolinska University Hospital Cervical Cytology Biobank, containing frozen cervical samples from >700,000 women participating in organized cervical screening, was linked to the Swedish national cervical screening registry to identify 470 stored cervical samples taken <180 days before histopathological diagnosis of CIN3+. Two controls per case, with no abnormal results for 2 screening rounds, matched for age and sampling time were also retrieved. Aliquots from 1406 women were retrieved and re-tested on the cobas 4800 system and tested on the cobas 6800 system. There was high reproducibility between the original cobas 4800 HPV test results, and the cobas 4800 HPV re-testing performed on the samples retrieved from biobank storage. 462/464 biobanked samples from women with CIN3+ tested HPV-positive on the cobas 6800 system, corresponding to a relative sensitivity of 99.6%. 925/932 biobanked samples from control women tested HPV-negative on the cobas 6800 platform, corresponding to a relative specificity of 99.2%. By conventional criteria, the cobas 6800 was non-inferior both regarding relative sensitivity of >90% (non-inferiority p-value <0.0001) and relative specificity of >98% (non-inferiority p-value 0.006). We conclude that the cobas 6800 HPV test system had similar, high performance as the cobas 4800 such, when evaluated using cervical samples taken before CIN3+ in a real-life primary HPV screening program.

scholarly journals Field Evaluation of Xpert HPV Point-of-Care Test for Detection of Human Papillomavirus Infection by Use of Self-Collected Vaginal and Clinician-Collected Cervical Specimens

2016 ◽  
Vol 54 (7) ◽  
pp. 1734-1737 ◽  
Author(s):  
P. Toliman ◽  
S. G. Badman ◽  
J. Gabuzzi ◽  
S. Silim ◽  
L. Forereme ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Low Income ◽  
Point Of Care ◽  
Cervical Screening ◽  
Field Evaluation ◽  
World Health ◽  
Low Income Countries ◽  
High Burden ◽  
Screening Programs ◽  
Hpv Test

The World Health Organization has recommended that testing for high-risk human papillomavirus (HPV) (hrHPV) infection be incorporated into cervical screening programs in all settings worldwide. In many high-burden, low-income countries, it will not be feasible to achieve high cervical screening coverage using hrHPV assays that require clinician-collected samples. We conducted the first evaluation of self-collected vaginal specimens compared with clinician-collected cervical specimens for the detection of hrHPV infection using the Xpert HPV test. Women aged 30 to 54 years attending two well-woman clinics in Papua New Guinea were invited to participate and provided self-collected vaginal and clinician-collected cervical cytobrush specimens. Both specimen types were tested at the point of care by using the Xpert HPV test. Women were given their cervical test result the same day. Those with a positive hrHPV test and positive examination upon visual inspection of the cervix with acetic acid were offered same-day cervical cryotherapy. A total of 1,005 women were enrolled, with 124 (12.3%; 95% confidence interval [CI], 10.3%, 14.4%) being positive for any hrHPV infection. There was a 99.4% overall percent agreement (OPA) between vaginal and cervical tests for HPV-16 (95% CI, 98.9%, 99.9%), a 98.5% OPA for HPV-18/45 (95% CI, 97.7%, 99.3%), a 94.4% OPA for other hrHPV infections (95% CI, 92.9%, 95.9%), and a 93.4% OPA for all hrHPV types combined (95% CI, 91.8%, 95.0%). Self-collected vaginal specimens had excellent agreement with clinician-collected cervical specimens for the detection of hrHPV infection using the Xpert HPV test. This approach provides for the first time an opportunity to incorporate point-of-care hrHPV testing into clinical cervical screening algorithms in high-burden, low-income settings.

scholarly journals A comparison of ThinPrep-PreservCyt against four non-volatile transport media for HPV testing at or near the point of care

2020 ◽  
Author(s):  
S.G. Badman ◽  
A.J. Vallely ◽  
C. Pardo ◽  
L.P. Mhango ◽  
A.M. Cornall ◽  
...  
Keyword(s):  
Point Of Care ◽  
Cervical Screening ◽  
Cell Types ◽  
Point Of Care Testing ◽  
Middle Income ◽  
Suitable Alternative ◽  
Hpv Test ◽  
The Media ◽  
Media Types ◽  
Volatile Transport

AbstractIntroductionThe Xpert HPV Test (Cepheid, Sunnyvale, CA) is used at point-of-care for cervical screening in a number of low-and middle-income countries (LMIC). It is validated for use with ThinPrep-PreservCyt (Hologic, Marlborough, MA) transport medium which has a high methanol content and is therefore classified as a dangerous good for shipping; making cost, transportation and use challenging within LMIC. Therefore, we compared the performance of ThinPrep against four non-volatile commercially available media for HPV point-of-care testing.MethodsTen-fold serial dilutions were prepared using three HPV cell lines each positive for 16, 18 or 31 and with each suspended in five different media types. The media types consisted of Phosphate Buffered Saline (Thermo Fischer Scientific, Waltham, MA, USA), Sigma Virocult (Medical Wire & Equipment, Wiltshire, England), MSwab (Copan, Brescia BS, Italy) Xpert Transport Media (Cepheid, Sunnyvale, USA) and ThinPrep-PreservCyt (Hologic Inc., Marlborough, MA).ResultsA total of 105 HPV Xpert tests were conducted in a laboratory setting, with 7 ten-fold dilutions of each of the 3 HPV genotypes tested in all 5 media types. The lowest HPV ten-fold dilution detected for any media, or cell line was the fifth dilution. Mswab was the only media to detect HPV to the 5th dilution across all three cell types.DiscussionMswab transport media may be a suitable alternative to ThinPrep for Xpert HPV point of care testing and increase HPV detection. A field-based, head to head comparison of both media types using the Xpert HPV assay is warranted to confirm these laboratory-based findings.

Comparing immunochromatography with latex antigen agglutination testing for the diagnosis of cryptococcosis in cats, dogs and koalas

2019 ◽  
Vol 58 (1) ◽  
pp. 39-46 ◽  
Author(s):  
Mark B Krockenberger ◽  
Caroline Marschner ◽  
Patricia Martin ◽  
George Reppas ◽  
Catriona Halliday ◽  
...  
Keyword(s):  
Gold Standard ◽  
Screening Test ◽  
Large Scale ◽  
Point Of Care ◽  
High Specificity ◽  
Agglutination Test ◽  
Test Results ◽  
Predictive Values ◽  
Cryptococcal Antigen ◽  
Rule Out

AbstractAlthough the point-of-care cryptococcal antigen lateral flow assay (LFA) has revolutionized the diagnosis of cryptococcosis in human patients, to date there has been no large-scale examination of this test in animals. We therefore assessed the LFA in cats, dogs and koalas suspected of having cryptococcosis. In sum, 528 serum specimens (129 from cats, 108 from dogs, 291 from koalas) were tested using the LFA and one of two commercially available latex cryptococcal antigen agglutination test (LCAT) kits. The LCAT is a proven and well-accepted method in veterinary patients and therefore taken as the “gold standard” against which the LFA was compared. The LFA achieved a sensitivity of 92%, 100%, and 98% in cats, dogs, and koalas, respectively, with corresponding negative predictive values of 94%, 100%, and 98%. The specificity of the LFA was 81%, 84%, and 62% for cats, dogs, and koalas, respectively, with corresponding positive predictive values of 76%, 48%, and 69%. These findings suggest the most appropriate role for the LFA is as a screening test to rule out a diagnosis of cryptococcosis in cats, dogs, and koalas. Point-of-care accessibility makes it equally suited for use in the field and as a cage-side test in veterinary hospitals. The suboptimal specificity of the LFA makes it less suited to definitive confirmation of cryptococcosis in animals; therefore, all LFA-positive test results should be confirmed by LCAT testing. The discrepancy between these observations and the high specificity of the LFA in humans may reflect differences in the host-pathogen interactions amongst the species.

scholarly journals HPV testing compared with routine cytology in cervical screening: long-term follow-up of ARTISTIC RCT

2019 ◽  
Vol 23 (28) ◽  
pp. 1-44 ◽  
Author(s):  
Clare Gilham ◽  
Alexandra Sargent ◽  
Henry C Kitchener ◽  
Julian Peto
Keyword(s):  
Human Papillomavirus ◽  
Cervical Screening ◽  
Hpv Infection ◽  
Cancer Registration ◽  
Hpv Testing ◽  
Cervical Intraepithelial Neoplasia Grade ◽  
Normal Cytology ◽  
Hpv Test ◽  
Hpv Screening

Background The National Screening Committee (NSC) based its recommendation that human papillomavirus (HPV) testing should replace cytology in primary cervical screening largely on the 2009 follow-up results of the ARTISTIC trial (A Randomised Trial In Screening To Improve Cytology). The NSC must now decide on screening intervals and triage policy. Options include extending the screening interval up to 10 years for human papillomavirus-negative (HPV–) women, delaying recall for human papillomavirus-positive (HPV+) women with normal cytology (as their infections are usually transient), and basing triage on full HPV typing. Methods In ARTISTIC, 24,510 women were recruited who were attending routine cervical cytology in Greater Manchester in 2001–3. The women were randomly allocated between revealing and concealing their HPV test results and were recalled every 3 years. After 2009, the women returned to routine cytological screening with recall every 3 years for those aged < 50 years, and every 5 years for those aged 50–64 years. We have followed the cohort to 2015 through national cancer registration for CIN3 (cervical intraepithelial neoplasia grade 3) and cancer, and through linkage to the cervical screening call–recall system to obtain lifetime cytology records. Results The analysis comprised 24,496 women at round 1 and 13,591 women at round 2 (which was 30–48 months later). Follow-up via local histology laboratories and national cancer registration identified 505 cases of cervical intraepithelial neoplasia grade 3 or cervical cancer (CIN3+) (including 22 invasive cervical cancers). The cumulative CIN3+ risk 10 years after a negative HPV test [0.31%, 95% confidence interval (CI) 0.18% to 0.49%, in the revealed arm] was similar to that 3 years after negative cytology (0.30%, 95% CI 0.23% to 0.41%, in the concealed arm) and fell sharply with age, from 1.1% (95% CI 0.7% to 1.8%) in those women aged < 25 years to 0.08% (95% CI 0.03% to 0.20%) in those women aged > 50 years. The 10-year cumulative CIN3+ risk following a new HPV infection at round 2 was 3.4% (95% CI 2.1% to 5.4%). The highest risks were associated with type-specific persistent infections that, overall, resulted in a 10-year cumulative CIN3+ risk of 20.4% (95% CI 15.6% to 26.4%). Conclusions We found a similar level of protection 10 years after a negative HPV test and 3 years after negative cytology. These data support a considerably longer screening interval after a negative HPV test than after a negative cytology test. About three-quarters of women with HPV infection and normal cytology clear their infections within about 3 years. Their risk of CIN3+ within this time frame is low (1.5%), suggesting that the current policy of annual repeat testing and referral after 2 years may be unnecessarily cautious. Approximately 40% of women who remained HPV+ had cleared their initial infection and acquired a new HPV type. The cumulative CIN3+ risks in women with type-specific persistent infections are about six times higher than in women with new infections. Triage strategies based on HPV persistence would, therefore, reduce unnecessary referral of women with new (and largely transient) infections. HPV assays that identify HPV types 31, 33, 45, 52 and 58 in addition to 16 and 18 could be useful in triage as well as in primary HPV testing. Similar results in recent routine HPV screening suggest that our results are generalisable despite changes in cytology and HPV assay methods. We are continuing to follow the ARTISTIC cohort into the new era of primary HPV screening. Future work will focus on the implications of more sensitive HPV testing for primary HPV screening policy and triage of HPV-positive women. Our results suggest that a more sensitive test is needed to detect occult CIN3 at high risk of progression to cancer, but this would substantially increase the overall HPV detection rate. Tests such as DNA (deoxyribonucleic acid) methylation for distinguishing HPV infection from neoplasia will be evaluated on stored samples and on further samples now being collected from women in the cohort who are still being screened. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 28. See the NIHR Journals Library website for further project information.

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