Yamal, Jose-MiguelZewdie, Getie A.Cox, Dennis D.Atkinson, E. NeelyCantor, Scott B.MacAulay, CalumDavies, KalatuAdewole, IsaacBuys, Timon P. H.Follen, Michele2013-04-032013-04-032012-04Yamal, Jose-Miguel, Zewdie, Getie A., Cox, Dennis D., et al.. "Accuracy of optical spectroscopy for the detection of cervical intraepithelial neoplasia without colposcopic tissue information; a step toward automation for low resource settings." <i>Journal of Biomedical Optics,</i> 17, no. 4 (2012) Society of Photo-Optical Instrumentation Engineers: 47002. http://dx.doi.org/10.1117/1.JBO.17.4.047002.https://hdl.handle.net/1911/70897Optical spectroscopy has been proposed as an accurate and low-cost alternative for detection of cervical intraepithelial neoplasia. We previously published an algorithm using optical spectroscopy as an adjunct to colposcopy and found good accuracy (sensitivity ¼ 1.00 [95% confidence interval ðCIÞ ¼ 0.92 to 1.00], specificity ¼ 0.71 [95% CI ¼ 0.62 to 0.79]). Those results used measurements taken by expert colposcopists as well as the colposcopy diagnosis. In this study, we trained and tested an algorithm for the detection of cervical intraepithelial neoplasia (i.e., identifying those patients who had histology reading CIN 2 or worse) that did not include the colposcopic diagnosis. Furthermore, we explored the interaction between spectroscopy and colposcopy, examining the importance of probe placement expertise. The colposcopic diagnosis-independent spectroscopy algorithm had a sensitivity of 0.98 (95% CI ¼ 0.89 to 1.00) and a specificity of 0.62 (95% CI ¼ 0.52 to 0.71). The difference in the partial area under the ROC curves between spectroscopy with and without the colposcopic diagnosis was statistically significant at the patient level (p ¼ 0.05) but not the site level (p ¼ 0.13). The results suggest that the device has high accuracy over a wide range of provider accuracy and hence could plausibly be implemented by providers with limited training.engArticle is made available in accordance with the publisher's policy and may be subject to US copyright law. Please refer to the publisher's site for terms of use.Journal articlesensitivity and specificitydiagnosisearly detection of canceruterine cervical neoplasmscervical intraepithelial neoplasiahttp://dx.doi.org/10.1117/1.JBO.17.4.047002