OBJECTIVE: To observe skill transfer for detection of clinical abnormalities in the breast by determining kappa agreement, sensitivity, specificity, positive predictive value and negative predictive value of clinical breast examination by female community health workers (FCHVs) considering surgeon findings as the gold standard. METHOD: This cross-sectional study was conducted in Dharan Municipality, Eastern Nepal for period of one year from June 2008 to May 2009. A total of 1,238 women were examined by both a FCHV and the surgeon. RESULT: The interobserver kappa agreement for the detection of clinical abnormalities in breast was 67% indicating a good agreement. Sensitivity, specificity, positive predictive value and negative predictive values of "FCHVs' clinical breast examination" to detect clinical abnormalities in breast in comparison to the surgeon's were 70%, 95%, 74% and 94% respectively. CONCLUSION: In view of good clinical breast examination skill transfer to FCHVs for detection of clinical abnormalities in breast, we conclude effective training of FCHVs may be a feasble approach for diagnosis of breast abnormalities in rural Nepal.
OBJECTIVE: To observe skill transfer for detection of clinical abnormalities in the breast by determining kappa agreement, sensitivity, specificity, positive predictive value and negative predictive value of clinical breast examination by female community health workers (FCHVs) considering surgeon findings as the gold standard. METHOD: This cross-sectional study was conducted in Dharan Municipality, Eastern Nepal for period of one year from June 2008 to May 2009. A total of 1,238 women were examined by both a FCHV and the surgeon. RESULT: The interobserver kappa agreement for the detection of clinical abnormalities in breast was 67% indicating a good agreement. Sensitivity, specificity, positive predictive value and negative predictive values of "FCHVs' clinical breast examination" to detect clinical abnormalities in breast in comparison to the surgeon's were 70%, 95%, 74% and 94% respectively. CONCLUSION: In view of good clinical breast examination skill transfer to FCHVs for detection of clinical abnormalities in breast, we conclude effective training of FCHVs may be a feasble approach for diagnosis of breast abnormalities in rural Nepal.
Authors: Ophira Ginsburg; Cheng-Har Yip; Ari Brooks; Anna Cabanes; Maira Caleffi; Jorge Antonio Dunstan Yataco; Bishal Gyawali; Valerie McCormack; Myrna McLaughlin de Anderson; Ravi Mehrotra; Alejandro Mohar; Raul Murillo; Lydia E Pace; Electra D Paskett; Anya Romanoff; Anne F Rositch; John R Scheel; Miriam Schneidman; Karla Unger-Saldaña; Verna Vanderpuye; Tsu-Yin Wu; Safina Yuma; Allison Dvaladze; Catherine Duggan; Benjamin O Anderson Journal: Cancer Date: 2020-05-15 Impact factor: 6.860