Assessment of a colposcopic scoring system (Swedescore) to reduce the number of cervical biopsies: a protocol for a clinical multicentre non-randomised intervention study in Denmark

Introduction Colposcopy is a standard procedure for evaluating cervical abnormalities and collecting cervical biopsies. The procedure is associated with intra- and inter-observer variation. A colposcopic scoring system, Swedescore, has been designed to standardise and facilitate colposcopy training....

Full description

Saved in:
Bibliographic Details
Main Authors: Ulrik Schiøler Kesmodel, Ameli Tropé, Anne Hammer, Pekka Nieminen, Björn Strander, Berit Booth, Ane-Kersti Skaarup Knudsen, Tina Hovgaard Randrup, Line Gustafson
Format: Article
Language:English
Published: BMJ Publishing Group 2024-12-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/14/12/e085382.full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850114011188690944
author Ulrik Schiøler Kesmodel
Ameli Tropé
Anne Hammer
Pekka Nieminen
Björn Strander
Berit Booth
Ane-Kersti Skaarup Knudsen
Tina Hovgaard Randrup
Line Gustafson
author_facet Ulrik Schiøler Kesmodel
Ameli Tropé
Anne Hammer
Pekka Nieminen
Björn Strander
Berit Booth
Ane-Kersti Skaarup Knudsen
Tina Hovgaard Randrup
Line Gustafson
author_sort Ulrik Schiøler Kesmodel
collection DOAJ
description Introduction Colposcopy is a standard procedure for evaluating cervical abnormalities and collecting cervical biopsies. The procedure is associated with intra- and inter-observer variation. A colposcopic scoring system, Swedescore, has been designed to standardise and facilitate colposcopy training. Swedescore has performed well in a routine clinical setting when used by expert colposcopists to find or exclude high-grade lesions. Danish clinical guidelines for colposcopy differ from other countries, as they recommend collecting four cervical biopsies in all women regardless of risk factors or colposcopy findings. Swedescore has never been examined to assess the reduction of cervical biopsies in a real-world clinical setting. This study aims to investigate whether the implementation of Swedescore can optimise the diagnostic work-up for whom the collection of biopsies can be safely omitted or reduced.Methods and analysis The design is a clinical multicentre non-randomised intervention study in Denmark. According to a power calculation, we will need to include 586 women referred for colposcopy. Colposcopy with Swedescore will be compared with conventional colposcopy with no Swedescore. Cervical biopsies will be divided into two separate vials (target and random biopsies). The primary outcome will be normal or cervical intraepithelial neoplasia grade 1 detected in cervical biopsies. χ2 and logistic regression will be used to compare estimates between arms.Ethics and dissemination The study protocol has been submitted to the Ethical Committee in Central Denmark region and is not notifiable to the Committee (j.no.: 1-10-72-124-22). Results will be published in a peer-reviewed journal and presented at scientific meetings.Trial registration number NCT05870787.Protocol version Version 3 (date 12. November 2024).
format Article
id doaj-art-7edfb465040e446286f027cc26fcc2c0
institution OA Journals
issn 2044-6055
language English
publishDate 2024-12-01
publisher BMJ Publishing Group
record_format Article
series BMJ Open
spelling doaj-art-7edfb465040e446286f027cc26fcc2c02025-08-20T02:36:59ZengBMJ Publishing GroupBMJ Open2044-60552024-12-01141210.1136/bmjopen-2024-085382Assessment of a colposcopic scoring system (Swedescore) to reduce the number of cervical biopsies: a protocol for a clinical multicentre non-randomised intervention study in DenmarkUlrik Schiøler Kesmodel0Ameli Tropé1Anne Hammer2Pekka Nieminen3Björn Strander4Berit Booth5Ane-Kersti Skaarup Knudsen6Tina Hovgaard Randrup7Line Gustafson81 Department of Clinical Medicine, Aarhus University, Aarhus, Midtjylland, Denmark8 Section for Cervical Cancer Screening, Cancer Registry of Norway, Oslo, Norway1 Department of Clinical Medicine, Aarhus University, Aarhus, Midtjylland, Denmark10 Helsinki University, Finland, Helsingin Yliopisto, Helsinki, Finland9 Department of Obstetrics and Gynecology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden4 The Research Unit of Obstetrics & Gynecology, Odense University Hospital, Odense University Hospital, Odense, The Region of Southern Denmark, Denmark1 Department of Clinical Medicine, Aarhus University, Aarhus, Midtjylland, Denmark2 Department of Obstetrics and Gynecology, Gødstrup Hospital, Herning 7400, Denmark6 Department of Public Health Programmes, Randers Regional Hospital, Randers, DenmarkIntroduction Colposcopy is a standard procedure for evaluating cervical abnormalities and collecting cervical biopsies. The procedure is associated with intra- and inter-observer variation. A colposcopic scoring system, Swedescore, has been designed to standardise and facilitate colposcopy training. Swedescore has performed well in a routine clinical setting when used by expert colposcopists to find or exclude high-grade lesions. Danish clinical guidelines for colposcopy differ from other countries, as they recommend collecting four cervical biopsies in all women regardless of risk factors or colposcopy findings. Swedescore has never been examined to assess the reduction of cervical biopsies in a real-world clinical setting. This study aims to investigate whether the implementation of Swedescore can optimise the diagnostic work-up for whom the collection of biopsies can be safely omitted or reduced.Methods and analysis The design is a clinical multicentre non-randomised intervention study in Denmark. According to a power calculation, we will need to include 586 women referred for colposcopy. Colposcopy with Swedescore will be compared with conventional colposcopy with no Swedescore. Cervical biopsies will be divided into two separate vials (target and random biopsies). The primary outcome will be normal or cervical intraepithelial neoplasia grade 1 detected in cervical biopsies. χ2 and logistic regression will be used to compare estimates between arms.Ethics and dissemination The study protocol has been submitted to the Ethical Committee in Central Denmark region and is not notifiable to the Committee (j.no.: 1-10-72-124-22). Results will be published in a peer-reviewed journal and presented at scientific meetings.Trial registration number NCT05870787.Protocol version Version 3 (date 12. November 2024).https://bmjopen.bmj.com/content/14/12/e085382.full
spellingShingle Ulrik Schiøler Kesmodel
Ameli Tropé
Anne Hammer
Pekka Nieminen
Björn Strander
Berit Booth
Ane-Kersti Skaarup Knudsen
Tina Hovgaard Randrup
Line Gustafson
Assessment of a colposcopic scoring system (Swedescore) to reduce the number of cervical biopsies: a protocol for a clinical multicentre non-randomised intervention study in Denmark
BMJ Open
title Assessment of a colposcopic scoring system (Swedescore) to reduce the number of cervical biopsies: a protocol for a clinical multicentre non-randomised intervention study in Denmark
title_full Assessment of a colposcopic scoring system (Swedescore) to reduce the number of cervical biopsies: a protocol for a clinical multicentre non-randomised intervention study in Denmark
title_fullStr Assessment of a colposcopic scoring system (Swedescore) to reduce the number of cervical biopsies: a protocol for a clinical multicentre non-randomised intervention study in Denmark
title_full_unstemmed Assessment of a colposcopic scoring system (Swedescore) to reduce the number of cervical biopsies: a protocol for a clinical multicentre non-randomised intervention study in Denmark
title_short Assessment of a colposcopic scoring system (Swedescore) to reduce the number of cervical biopsies: a protocol for a clinical multicentre non-randomised intervention study in Denmark
title_sort assessment of a colposcopic scoring system swedescore to reduce the number of cervical biopsies a protocol for a clinical multicentre non randomised intervention study in denmark
url https://bmjopen.bmj.com/content/14/12/e085382.full
work_keys_str_mv AT ulrikschiølerkesmodel assessmentofacolposcopicscoringsystemswedescoretoreducethenumberofcervicalbiopsiesaprotocolforaclinicalmulticentrenonrandomisedinterventionstudyindenmark
AT amelitrope assessmentofacolposcopicscoringsystemswedescoretoreducethenumberofcervicalbiopsiesaprotocolforaclinicalmulticentrenonrandomisedinterventionstudyindenmark
AT annehammer assessmentofacolposcopicscoringsystemswedescoretoreducethenumberofcervicalbiopsiesaprotocolforaclinicalmulticentrenonrandomisedinterventionstudyindenmark
AT pekkanieminen assessmentofacolposcopicscoringsystemswedescoretoreducethenumberofcervicalbiopsiesaprotocolforaclinicalmulticentrenonrandomisedinterventionstudyindenmark
AT bjornstrander assessmentofacolposcopicscoringsystemswedescoretoreducethenumberofcervicalbiopsiesaprotocolforaclinicalmulticentrenonrandomisedinterventionstudyindenmark
AT beritbooth assessmentofacolposcopicscoringsystemswedescoretoreducethenumberofcervicalbiopsiesaprotocolforaclinicalmulticentrenonrandomisedinterventionstudyindenmark
AT anekerstiskaarupknudsen assessmentofacolposcopicscoringsystemswedescoretoreducethenumberofcervicalbiopsiesaprotocolforaclinicalmulticentrenonrandomisedinterventionstudyindenmark
AT tinahovgaardrandrup assessmentofacolposcopicscoringsystemswedescoretoreducethenumberofcervicalbiopsiesaprotocolforaclinicalmulticentrenonrandomisedinterventionstudyindenmark
AT linegustafson assessmentofacolposcopicscoringsystemswedescoretoreducethenumberofcervicalbiopsiesaprotocolforaclinicalmulticentrenonrandomisedinterventionstudyindenmark