An Intelligent Clinical Decision Support System for Patient-Specific Predictions to Improve Cervical Intraepithelial Neoplasia Detection
Table 18
Performance of several type “OR” combinations between more than two tests in detecting CIN2+.
Combinations of medical tests
Cytology cutoff
Sensitivity (%)
Specificity (%)
PPV (%)
NPV (%)
Youden’s index
Pap test or HPV DNA or NASBA
ASCUS+
99.4
36.6
30.4
99.5
0.36
Pap test or HPV DNA or NASBA
LSIL+
96.3
51.1
35.4
98.0
0.47
Pap test or HPV DNA or NASBA
HSIL+
96.3
59.1
39.5
98.3
0.55
Pap test or HPV DNA or FLOW
ASCUS+
100.0
35.1
30.0
100.0
0.35
Pap test or HPV DNA or FLOW
LSIL+
98.1
48.9
34.8
99.0
0.47
Pap test or HPV DNA or FLOW
HSIL+
98.1
56.0
38.3
99.1
0.54
Pap test or HPV DNA or p16
ASCUS+
99.4
37.5
30.7
99.5
0.37
Pap test or HPV DNA or p16
LSIL+
96.3
51.3
35.5
98.0
0.48
Pap test or HPV DNA or p16
HSIL+
96.3
58.9
39.4
98.3
0.55
Pap test or HPV DNA or NASBA or FLOW
ASCUS+
100.0
34.9
29.9
100.0
0.35
Pap test or HPV DNA or NASBA or FLOW
LSIL+
98.1
48.7
34.7
98.9
0.47
Pap test or HPV DNA or NASBA or FLOW
HSIL+
98.1
55.4
38.0
99.1
0.54
Pap test or HPV DNA or NASBA or FLOW or p16
ASCUS+
100.0
34.9
29.9
100.0
0.35
Pap test or HPV DNA or NASBA or FLOW or p16
LSIL+
98.1
48.0
34.4
98.9
0.46
Pap test or HPV DNA or NASBA or FLOW or p16
HSIL+
98.1
54.4
37.4
99.1
0.53
HPV DNA or NASBA or FLOW
98.1
56.1
38.3
99.1
0.54
HPV DNA or NASBA or p16
93.8
58.5
38.6
97.1
0.52
HPV DNA or NASBA or FLOW or p16
98.1
54.7
37.6
99.1
0.53
NASBA or FLOW or p16
98.1
76.7
53.9
99.3
0.75
Statistical measures have been calculated using all cases of the dataset (Table 1). Histology endpoint is CIN2+ for all cases. Definition of positivity of each medical test is presented in Table 15. CIN2+: cervical intraepithelial neoplasia grade 2 or worse, HR-HPV: high-risk human papillomavirus, NASBA: nucleic acid sequence based amplification for the identification of E6/E7 mRNA of the HPV types 16, 18, 31, 33, and 45, FLOW: flow cytometric E6/E7 HPV mRNA assay, PPV: positive predictive value, and NPV: negative predictive value.
