Efficacy of cervical-smear collection devices: a systematic review and meta-analysis.
Background: Few randomised controlled trials have sufficient power to show clear advantages of different designs of cervical-smear collection devices. We studied by systematic review whether the design of cervical-smear devices affects rates of inadequate smears and detection of disease and whether...
| Publicado en: | Lancet Vol. 354; no. 9192; pp. 1763 - 1771 |
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| Autores principales: | , , , , , , , |
| Formato: | pictorial research systematic review tables/charts Journal Article |
| Publicado: |
Lancet
11/20/1999
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=107084386&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 107084386 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01406736 LAN jtl: Lancet issn: 01406736 maglogo: N pubinfo: dt: 11/20/1999 vid: 354 iid: 9192 pid: 1297 pub: Lancet place: Philadelphia, Pennsylvania artinfo: ui: 107084386 107084386 NLM10577637 2000003632 10.1016/s0140-6736(99)02353-3 NLM10577637 107084386 ppf: 1763 ppct: 8 formats: fmt: @attributes: type: P tig: atl: Efficacy of cervical-smear collection devices: a systematic review and meta-analysis. aug: au: Martin-Hirsch P Lilford R Jarvis G Kitchener HC Martin-Hirsch, P Lilford, R Jarvis, G Kitchener, H C affil: University Department of Obstetrics and Gynaecology, St Mary's Hospital, Manchester, UK sug: subj: Cervical Smears Equipment and Supplies Equipment Design Odds Ratio Confidence Intervals Cervix Pathology Quality Control (Technology) Cervix Neoplasms Diagnosis Meta Analysis Funding Source Human ab: Background: Few randomised controlled trials have sufficient power to show clear advantages of different designs of cervical-smear collection devices. We studied by systematic review whether the design of cervical-smear devices affects rates of inadequate smears and detection of disease and whether the presence of endocervical cells in the smear affects detection of disease.Methods: We sought relevant randomised controlled trials by computer literature review by MEDLINE backed up by a manual search of 16 journals. Each trial was classified according to methodological quality criteria. Odds ratios were calculated where data allowed.Findings: 34 randomised controlled trials investigating cervical Papanicolaou smear collection devices were identified. All 34 trials compared the ability of devices to collect endocervical cells, and 19 compared the ability of devices to detect dyskaryosis. Meta-analyses showed that compared with other collection devices, the Ayre's spatula is an ineffective device for collecting endocervical cells (for example, odds ratio for comparison of extended-tip spatulas vs Ayre's spatula 2.25 [95% CI 2.06-2.44]) and also gives a lower yield of dyskaryosis (odds ratio for comparison of extended-tip spatulas vs Ayre's spatula 1.21 [1.20-1.33]). Devices that effectively collect endocervical cells also detect a higher proportion of abnormal cytology than those that do not.Interpretation: The widely used Ayre's spatula is the least effective device for cervical sampling and should be superseded by extended-tip spatulas for primary screening and investigation of women before and after treatment for cervical intraepithelial neoplasia. The presence of endocervical cells is a valid and convenient surrogate for the ability to detect dyskaryosis. pubtype: Academic Journal doctype: pictorial research systematic review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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