• Title/Summary/Keyword: False-negative results

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Evaluation of a Serodiagnostic Method for Tuberculosis by Using Secreted Protein Antigens of Mycobacterium Tuberculosis (결핵균 분비항원을 이용한 결핵의 혈청학적 진단 방법에 대한 평가)

  • Bai, Gill-Han;Park, Eun-Mi;Kim, Sang-Jae
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.3
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    • pp.315-323
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    • 2000
  • Background : An immunochromatographic assay (ICT Diagnostics) which facilitates the diagnosis of tuberculosis(TB) by detecting serum antibodies mainly directed against specific 38KDa of Mycobacterium tuberculosis has come into the market. The test consists of a cardboard folding device containing nitrocellulose strip and absorbent pads. The whole procedure is completed within 15 min and does not require any additional equipment. The test has been reported to be sensitive and specific in diagnosing active TB. Thus the test had been evaluated with sera from TB patients and TB-free subjects. Method : Sera from patients with active pulmonary tuberculosis(40 sputum positives for Mycobacterium tuberculosis, 79 sputum negatives, and 3 extrapulmonary tuberculosis) were obtained from the Double-Cross Chest Clinic of the Korean National Tuberculosis Association (KNTA) in Seoul. The control group consisted of TB-free 68 subjects(21 children under 7 years old and 47 healthy staff members of KNTA). Results : Nine out of 68(13.2%) TB-free controls had positive antibody response. Total 106 of 122(86.9%) radiologically active patients had positive antibodies while 16 (13.1%) showed negative reaction. Antibody was detected in 38 of 40(95.0%) sputum positive patients and 68 of 82(82.9%) sputum negative patients who were under the antituberculosis chemotherapy. The sensitivity and specificity were all 87% and the positive predictive value was 92.2% while the negative predictive value was 78.7%, when the prevalence of TB in the sample was 64.2%. Our results clearly show that the detection of antibodies which mainly react with the 38KDa antigen of M. tuberculosis is not suitable as the first-line method of diagnosis but considered only as an adjunctive test to standard techniques of tuberculosis diagnosis. when considering its high false positivity.

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Establishment of Reference Range of Proinsulin (Proinsulin 참고치 설정에 관한 연구)

  • Nam, Yee Moon;Shin, Yong Hwan;Kim, Ji Young;Seok, Jae Dong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.1
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    • pp.76-79
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    • 2013
  • Purpose: It is very important to establish the appropriate reference range in the laboratory for preventing mistakes like false positive or false negative. Because the reference range in the laboratory is standard of patient test results interpretation. Proinsulin is precursor hormone of insulin, and the importance is increasing for diagnosing diabetes or insulinoma. Proinsulin reagent used in our laboratory is produced in the USA, and the reference range provided by manufacturer was adapted to our reference range after the validation test. But, it is generally recommend for the every laboratory to establish the their own reference range. So, we decided to re-evaluate the reference range with our patients' test results. Materials and Methods: Among 737 patients who had been to health promotion center in our hospital between Dec. $8^{th}$ 2011 and Dec. $21^{st}$ 2011, 563 patients are chosen with exception of diabetics patients and patients showing abnormal test results in Fasting Glucose, HbA1c, Insulin, and C-peptide. The 563 test results (275 males and 288 females) were classified with three groups(entire, male, female), and analysis of normal distribution was performed with aid of SPSS(version 19.0). Because Each group didn't show normal distribution, the reference range was set from the lowest limit of 2.5% to the highest limit of 97.5% with Percentile method used in non-normal distribution. Results: When evaluation values are sorted in ascending order, the entire range is 4.5~52.0 pM and 5.3~51.9 pM for male and 4.5~52.0 pM for female. The calculated reference range with percentile method shows 6.7~26.5 pM for entire group, 6.8~26.5 pM for male and 6.7~26.5 pM for female, respectively. Conclusion: The reference range provided by reagent manufacturer is 6.4~9.4 pM and the one established in this study is 6.7~26.5 pM. This difference might be caused by racial characteristics between Western people and Koreans. So an ideal reference range can be gotten with normal population visiting to every hospital. Our hospital has been using the newly re-establishing reference range under consultation with the department of endocrinology since Aug. $1^{st}$ 2012.

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Utility of a multiplex reverse transcriptase-polymerase chain reaction assay (HemaVision) in the evaluation of genetic abnormalities in Korean children with acute leukemia: a single institution study

  • Kim, Hye-Jin;Oh, Hyun Jin;Lee, Jae Wook;Jang, Pil-Sang;Chung, Nack-Gyun;Kim, Myungshin;Lim, Jihyang;Cho, Bin;Kim, Hack-Ki
    • Clinical and Experimental Pediatrics
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    • v.56 no.6
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    • pp.247-253
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    • 2013
  • Purpose: In children with acute leukemia, bone marrow genetic abnormalities (GA) have prognostic significance, and may be the basis for minimal residual disease monitoring. Since April 2007, we have used a multiplex reverse transcriptase-polymerase chain reaction tool (HemaVision) to detect of GA. Methods: In this study, we reviewed the results of HemaVision screening in 270 children with acute leukemia, newly diagnosed at The Catholic University of Korea from April 2007 to December 2011, and compared the results with those of fluorescence in situ hybridization (FISH), and G-band karyotyping. Results: Among the 270 children (153 males, 117 females), 187 acute lymphoblastic leukemia and 74 acute myeloid leukemia patients were identified. Overall, GA was detected in 230 patients (85.2%). HemaVision, FISH, and G-band karyotyping identified GA in 125 (46.3%), 126 (46.7%), and 215 patients (79.6%), respectively. TEL-AML1 (20.9%, 39/187) and AML1-ETO (27%, 20/74) were the most common GA in ALL and AML, respectively. Overall sensitivity of HemaVision was 98.4%, with false-negative results in 2 instances: 1 each for TEL-AML1 and MLL-AF4. An aggregate of diseases-specific FISH showed 100% sensitivity in detection of GA covered by HemaVision for actual probes utilized. G-band karyotype revealed GA other than those covered by HemaVison screening in 133 patients (49.3%). Except for hyperdiplody and hypodiploidy, recurrent GA as defined by the World Health Organizationthat were not screened by HemaVision, were absent in the karyotype. Conclusion: HemaVision, supported by an aggregate of FISH tests for important translocations, may allow for accurate diagnosis of GA in Korean children with acute leukemia.

F-18-FDG Whole Body Scan using Gamma Camera equipped with Ultra High Energy Collimator in Cancer Patients: Comparison with FDG Coincidence PET (종양 환자에서 초고에너지(511 keV) 조준기를 이용한 전신 F-18-FDG 평면 영상: Coincidence 감마카메라 단층 촬영 영상과의 비교)

  • Pai, Moon-Sun;Park, Chan-H.;Joh, Chul-Woo;Yoon, Seok-Nam;Yang, Seung-Dae;Lim, Sang-Moo
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.1
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    • pp.65-75
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    • 1999
  • Purpose: The aim of this study is to demonstrate the feasibility of 2-[fluorine-18] fluoro-2-deoxy-D-glucose (F-18-FDG) whole body scan (FDG W/B Scan) using dual-head gamma camera equipped with ultra high energy collimator in patients with various cancers, and compare the results with those of coincidence imaging. Materials and Methods: Phantom studies of planar imaging with ultra high energy and coincidence tomography (FDG CoDe PET) were performed. Fourteen patients with known or suspected malignancy were examined. F-18-FDG whole body scan was performed using dual-head gamma camera with high energy (511 keV) collimators and regional FDG CoDe PET immediately followed it Radiological, clinical follow up and histologic results were correlated with F-18-FDG findings. Results: Planar phantom study showed 13.1 mm spatial resolution at 10 cm with a sensitivity of 2638 cpm/MBq/ml. In coincidence PET, spatial resolution was 7.49 mm and sensitivity was 5351 cpm/MBq/ml. Eight out of 14 patients showed hypermetabolic sites in primary or metastatic tumors in FDG CoDe PET. The lesions showing no hypermetabolic uptake of FDG in both methods were all less than 1 cm except one lesion of 2 cm sized metastatic lymph node. The metastatic lymph nodes of positive FDG uptake were more than 1.5 cm in size or conglomerated lesions of lymph nodes less than 1cm in size. FDG W/B scan showed similar results but had additional false positive and false negative cases. FDG W/B scan could not visualize liver metastasis in one case that showed multiple metastatic sites in FDG CoDe PET. Conclusion: FDG W/B scan with specially designed collimators depicted some cancers and their metastatic sites, although it had a limitation in image quality compared to that of FDG CoDe PET. This study suggests that F-18-FDG positron imaging using dual-head gamma camera is feasible in oncology and helpful if it should be more available by regional distribution of FDG.

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An Integrated Model based on Genetic Algorithms for Implementing Cost-Effective Intelligent Intrusion Detection Systems (비용효율적 지능형 침입탐지시스템 구현을 위한 유전자 알고리즘 기반 통합 모형)

  • Lee, Hyeon-Uk;Kim, Ji-Hun;Ahn, Hyun-Chul
    • Journal of Intelligence and Information Systems
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    • v.18 no.1
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    • pp.125-141
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    • 2012
  • These days, the malicious attacks and hacks on the networked systems are dramatically increasing, and the patterns of them are changing rapidly. Consequently, it becomes more important to appropriately handle these malicious attacks and hacks, and there exist sufficient interests and demand in effective network security systems just like intrusion detection systems. Intrusion detection systems are the network security systems for detecting, identifying and responding to unauthorized or abnormal activities appropriately. Conventional intrusion detection systems have generally been designed using the experts' implicit knowledge on the network intrusions or the hackers' abnormal behaviors. However, they cannot handle new or unknown patterns of the network attacks, although they perform very well under the normal situation. As a result, recent studies on intrusion detection systems use artificial intelligence techniques, which can proactively respond to the unknown threats. For a long time, researchers have adopted and tested various kinds of artificial intelligence techniques such as artificial neural networks, decision trees, and support vector machines to detect intrusions on the network. However, most of them have just applied these techniques singularly, even though combining the techniques may lead to better detection. With this reason, we propose a new integrated model for intrusion detection. Our model is designed to combine prediction results of four different binary classification models-logistic regression (LOGIT), decision trees (DT), artificial neural networks (ANN), and support vector machines (SVM), which may be complementary to each other. As a tool for finding optimal combining weights, genetic algorithms (GA) are used. Our proposed model is designed to be built in two steps. At the first step, the optimal integration model whose prediction error (i.e. erroneous classification rate) is the least is generated. After that, in the second step, it explores the optimal classification threshold for determining intrusions, which minimizes the total misclassification cost. To calculate the total misclassification cost of intrusion detection system, we need to understand its asymmetric error cost scheme. Generally, there are two common forms of errors in intrusion detection. The first error type is the False-Positive Error (FPE). In the case of FPE, the wrong judgment on it may result in the unnecessary fixation. The second error type is the False-Negative Error (FNE) that mainly misjudges the malware of the program as normal. Compared to FPE, FNE is more fatal. Thus, total misclassification cost is more affected by FNE rather than FPE. To validate the practical applicability of our model, we applied it to the real-world dataset for network intrusion detection. The experimental dataset was collected from the IDS sensor of an official institution in Korea from January to June 2010. We collected 15,000 log data in total, and selected 10,000 samples from them by using random sampling method. Also, we compared the results from our model with the results from single techniques to confirm the superiority of the proposed model. LOGIT and DT was experimented using PASW Statistics v18.0, and ANN was experimented using Neuroshell R4.0. For SVM, LIBSVM v2.90-a freeware for training SVM classifier-was used. Empirical results showed that our proposed model based on GA outperformed all the other comparative models in detecting network intrusions from the accuracy perspective. They also showed that the proposed model outperformed all the other comparative models in the total misclassification cost perspective. Consequently, it is expected that our study may contribute to build cost-effective intelligent intrusion detection systems.

Comparative study of serological detection methods on old bloodstain samples (오래된 혈흔 시료에 대한 혈청학적 식별법의 비교 연구)

  • Lee, Minji;Ahn, Eu-Ree;Kim, Da-Hye;Shin, Heejin;Jung, Ju Yeon;Lee, Sung-Jin;Chun, Byung-Won
    • Analytical Science and Technology
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    • v.31 no.5
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    • pp.201-207
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    • 2018
  • Blood is a commonly found body fluid at crime scenes, and plays an important role in identifying suspects and in the reconstruction of crime scenes. Although serological detection of blood has been widely used in the field of forensic science, research on the detection of old bloodstains is scarce. This work aimed to compare various methods for the detection of old bloodstains and validate the reliability of their results. Four presumptive tests-Tetramethylbenzidine, $Bluestar^{(R)}$, Leucomalachite Green, Kastle-Meyer tests-and two confirmatory tests-Fecal Occult Blood (FOB) and Rapid Stain $Identification^{(TM)}-Blood$ ($RSID^{TM}-Blood$) tests-were compared. Bloodstain samples from post-mortem cases were collected on gauzes and then stored at room temperature for periods from 7 to 30 years. All the presumptive tests were positive, even for the 30-year-old sample. However, FOB and $RSID^{TM}-Blood$ provided false negative results for some samples stored for 17 years or more (1988 to 2001). The results indicate that FOB and $RSID^{TM}-Blood$ are not reliable for the detection of old bloodstains. These findings can be useful in the selection of an appropriate detection method for serological testing of old bloodstains. In addition, the information will be useful background knowledge when applied in the field of forensic practice.

The Effects of Multi-identity on One's Psychological State and the Quality of Contribution in Virtual Communities: A Socio-Psychological Perspective

  • Suh, A-Young;Shin, Kyung-Shik;Lee, Ju-Min
    • Asia pacific journal of information systems
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    • v.20 no.1
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    • pp.57-79
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    • 2010
  • In a virtual community, one can possess multiple identities and pretend to be different by creating self-identity in contrast with his or her actual self. Does false identity undermine the qualitative growth of a virtual community by reducing members' accountability? Or does it stimulate their contributive behaviors by ensuring freedom of speech? It is imperative to understand the effects of multi-identity considering the distinct properties of a virtual community in which people easily change their identities at little or no cost. To answer these questions, we adopted the concept of self-discrepancy from the social psychology theory rooted in the concept of the self and developed a theoretical model to predict quality of contribution of the individual member in virtual communities. Based on the self-discrepancy theory, we first identified two different domains of the self: (1) an "actual self" that consists of attributes that the person believes he or she currently possesses in real life and (2) a "cyber self" that consists of attributes the person believes he or she possesses in a virtual community. Next, we derived an index for two different types of self-discrepancy by using the differences between the actual and the cyber identities: Personal Self-discrepancy and Social Self-discrepancy. Personal Self-discrepancy reflects the degree of discrepancy between actual and cyber identity regarding a person's intelligence, education, and expertise. Social Self-discrepancy reflects the degree of discrepancy between actual and cyber identity regarding a person's morality, sociability, and accordance with social norms. Finally, we linked them with sense of virtual community, perceived privacy rights, and quality of contribution to examine how having a multi-identity influences an individual's psychological state and contributive behaviors in a virtual community. The results of the analysis based on 266 respondents showed that Social Self-discrepancy negatively influenced both the Sense of Virtual Community and Perceived Privacy Rights, while Personal Self-discrepancy negatively influenced only Perceived Privacy Rights, thereby resulting in reduced quality of contribution in virtual communities. Based on the results of this analysis, we can explain the dysfunctions of multi-identity in virtual communities. First, people who pretend to be different by engaging in socially undesirable behaviors under their alternative identities are more likely to suffer lower levels of psychological wellbeing and thus experience lower levels of sense of virtual community than others. Second, people do not perceive a high level of privacy rights reflecting catharsis, recovery, or autonomy, even though they create different selves and engage in socially undesirable behaviors in a virtual community. Third, people who pretend to be different persons in terms of their intelligence, education, or expertise also indirectly debase the quality of contribution by decreasing perceived privacy rights. The results suggest that virtual community managers should pay more attention to the negative influences exercised by multi-identity on the quality of contribution, thereby controlling the need to create alternative identities in virtual communities. We hope that more research will be conducted on this underexplored area of multi-identity and that our theoretical framework will serve as a useful conceptual tool for all endeavors.

Usefulness of $^{18}F-FDG$ PET/CT in the Diagnosis of Cervical Lymph Node Metastases of Head and Neck Cancer (두경부암 경부 림프절 전이의 진단에서 $^{18}F-FDG-PET/CT$의 유용성)

  • Kim, Chung-Ho;Kim, Sung-Hoon;O, Joo-Hyun;Yoo, Ie-Ryung;Chung, Yong-An;Park, Young-Ha;Sohn, Hyung-Sun;Lee, Sung-Young;Chung, Soo-Kyo
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.5
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    • pp.269-277
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    • 2005
  • Purpose: This study evaluated the diagnostic value of $^{18}F-FDG$ PET/CT in detecting cervical lymph node metastases in head and neck cancer patients. Materials & Methods: The patients were divided into two groups, 46 patients underwent PET/CT scan for initial staging before surgery, and 20 patients for restaging of recurrence after primary treatment. Increased FDG uptakes in cervical lymph nodes were evaluated retrospectively and correlated with the histopathologic results. Results: In the initial staging group, 21 lymph nodes were detected by PET/CT in 15 patients. 20 lymph nodes were confirmed as metastases with a mean peak SUV of 5.84, and the remaining one lymph node was an inflammatory lesion, with a peak SUV of 2.75. Seven metastatic lymph nodes were reported only by histopatholoay. The sensitivity, specificity, positive predictive value and negative predictive value were 74.0%, 99.6%, 95.2% and 97.3%, respectively. In the recurrence group, 11 lymph nodes were detected in 9 patients, and 8 nodes were true positive, with a mean peak SUV of 5.65. The other three were inflammatous lymph nodes, and the peak SUVs were 2.16, 2.94 and 3.53. One false negative lymph node was reported. The sensitivity, specificity, positive predictive value and negative predictive value were 88.8%, 97.7%, 72.7% and 92.9%, respectively. Conclusions: FDG-PET/CT shows higher positive predictive value in the initial staging group, and better sensitivity in the recurrence group. Therefore PET/CT could be useful for both initial staging and restaging of recurrent cervical lymph node metastases.

Real-time Nucleic Acid Sequence Based Amplification (Real-time NASBA) for Detection of Norovirus

  • Lee, In-Soo;Choi, Dong-Hyuk;Lim, Jae-Won;Cho, Yoon-Jung;Jeong, Hye-Sook;Cheon, Doo-Sung;Bang, Hye-Eun;Jin, Hyun-Woo;Choi, Yeon-Im;Park, Sang-Jung;Kim, Sung-hyun;Lee, Hye-Young;Kim, Tae-Ue
    • Biomedical Science Letters
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    • v.17 no.3
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    • pp.191-196
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    • 2011
  • Noroviruses (noroV) are the major cause of nonbacterial gastroenteritis in humans worldwide. Since noroV cannot yet be cultured in vitro and their diagnosis by electron microscopy requires at least $10^6$ viral particles/g of stool a variety of molecular detection techniques represent an important step towards the detection of noroV. In the present study, we have applied real-time nucleic acid sequence-based amplification (real-time NASBA) for simultaneous detection of NoroV genogroup I (GI) and genogroup II (GII) using standard viral RNA. For real-time NASBA assay which can detected noroV GI and GII, a selective region of the genes encoding the capsid protein was used to design primers and genotype-specific molecular beacon probes. The specificity of the real-time NASBA using newly designed primers and probes were confirmed using standard viral RNA of noroV GI and GII. To determine the sensitivity of this assay, serial 10-fold dilutions of standard viral RNA of noroV GI and GII were used for reverse transcription polymerase chain reaction (RT-PCR) and real-time NASBA. The results showed that while agarose gel electrophoresis could detect RT-PCR products with 10 pg of standard viral RNA, the real-time NASBA assay could detect 100 fg of standard viral RNA. These results suggested that the real-time NASBA assay has much higher sensitivity than conventional RT-PCR assay. This assay was expected that might detect the viral RNA in the specimens which could have been false negative by RT-PCR. There were needed to perform real-time NASBA with clinical specimens for evaluating accurate sensitivity and specificity of this assay.

Comparison between Visual Inspection of Cervix and Cytology Based Screening Procedures in Bangladesh

  • Nessa, Ashrafun;Nahar, Khadiza Nurun;Begum, Shirin Akhter;Anwary, Shahin Ara;Hossain, Fawzia;Nahar, Khairun
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7607-7611
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    • 2013
  • Background: Cervical cancer continues to be a major problem in Bangladesh with approximately 18,000 new cases annually of which over 10,000 women die from it. Visual inspection of the cervix after 3-5% acetic acid (VIA) application is a simple and easy to learn method for cervical cancer screening, although cytology-based screening is more often applied in developed countries where it has successfully reduced the prevalence of cervical cancer. Objective: To compare the efficacy of VIA and cytology-based primary methods for cervical cancer screening in Bangladesh. Materials and Methods: This hospital based comparative study was conducted at the VIA centre and Colposcopy Clinic of Bangabandhu Sheikh Mujib Medical University (BSMMU) from October 2008 to October 2010. Results: Among 650 women, 74 (11.4%) were VIA+ve and 8 (1.2%) had abnormalities in their Pap smear reports. During colposcopy, 38 (7.7%) women had different grades of CIN and 4 (0.6%) had cervical cancer. The gold standard histology findings proved 20 women had CIN I, 14 had CIN II/II and 4 had cervical cancer. Among the 38 histology diagnosed abnormalities, VIA test could identify 30 abnormalities including two cervical cancers. However, Pap smear could detect only 8 cases of histological abnormalities (2 low grade and 6 had high grade lesion) and it missed all the cervical cancer cases. The sensitivity and specificity of VIA were 88.9% and 52.1%. The positive predictive value (PPV) and negative predictive value (NPV) were 41.0%, and 92.6% respectively. Moreover, the sensitivity, specificity, PPV and NPV of Pap smear were 33.3%, 95.8%, 75.0% and 79.3%, respectively. Conclusions: VIA test should be used as the primary screening tool even with its low sensitivity and specificity in low resource countries like Bangladesh. False positive results may be greater, but overtreatment can be minimized by colposcopy evaluation of the VIA positive women.