Background: The mobile and online-connected EVA System colposcope allows providers to capture and annotate colposcopic images, connect for a live consultation, or observe beginning colposcopists remotely for quality assurance. An analysis was done on a high-risk patient population in California to explore if visualization using EVA at screening can improve patient management.

Methods: Colposcopy exam results recorded on the EVA System app from N=327 patients were analyzed retrospectively. The specific parameters of interest included colposcopic impression, latest cytology, and HPV test results, and other patient data including age and HIV status. These data were compared against histopathology results, obtained from patients’ medical records.

Results: For CIN 2+ histopathology, both HPV testing and cytology (ASCUS threshold) had an NPV of 1.00; cytology (LSIL threshold) had an NPV of 0.94, and visualization had an NPV of 0.89. In terms of PPV, visualization had the highest value of the various tests (0.45); the remaining tests ranged between 0.17-0.29. Similar results were found for CIN 3 histopathology, where visual colposcopic impression had a PPV of 0.146, higher than all other tests, which ranged between 0.04-0.09. In terms of test inadequacy rates, visualization failed to yield a result in <1% of cases. HPV, cytology, and histopathology had inadequacy rates of 20%, 4%, and 5%, respectively.

Conclusion: Visualization had a higher PPV and much lower inadequacy rates than HPV testing and cytology. This suggests it may have a role to play in triage of HPV+ patients. Further analysis of a screening population is needed.


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