In the context of opportunistic cervical cancer screening settings of low‐and‐middle‐income countries, little is known about the benefits of high‐risk human papillomavirus (hrHPV) testing on high‐grade cervical abnormality detection among women with atypical squamous cells of undetermined significance (ASC‐US) cytology in routine clinical practice. We compared the effectiveness of immediate colposcopy (IC), conventional cytology at 6 and 12 months (colposcopy if ≥ASC‐US) (RC) and hrHPV testing (colposcopy if hrHPV‐positive) (HPV) to detect cervical intraepithelial neoplasia grade 2 or more severe diagnoses (CIN2+) among women aged 20 to 69 years with ASC‐US in routine care. Participants (n = 2661) were evenly randomized into three arms (n = 882 IC, n = 890 RC, n = 889 HPV) to receive services by routine healthcare providers and invited to an exit visit 24 months after recruitment. Histopathology was blindly reviewed by a quality‐control external panel (QC). The primary endpoint was the first QC‐diagnosed CIN2+ or CIN3+ detected during three periods: enrolment (≤6 months for IC and HPV, ≤12 months for RC), follow‐up (between enrolment and exit visit) and exit visit. The trial is completed. Colposcopy was done on 88%, 42% and 52% of participants in IC, RC and HPV. Overall, 212 CIN2+ and 52 CIN3+ cases were diagnosed. No differences were observed for CIN2+ detection (P = .821). However, compared to IC, only HPV significantly reduced CIN3+ cases that providers were unable to detect during the 2‐year routine follow‐up (relative proportion 0.35, 95% CI 0.09‐0.87). In this context, hrHPV testing was the most effective and efficient management strategy for women with ASC‐US cytology.

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Objective: To evaluate and compare sensitivity and specificity of ANB, Wits, APDI and AF-BF to diagnose sagittal skeletal malocclusions, in children between 6 to 12 years old, using ROC curves, a widely accepted method for the analysis and evaluation of diagnostic tests. Material and Methods: A descriptive-comparative study of diagnostic tests was conducted. From a population of 3,000 children, a non-probabilistic sample of 209 was selected. The clinical classification of the patients as class I, II or III, made by a group of experts based on the visual inspection of models and photographs, was chosen as the gold standard. After calibration (ICC>0.94) the variables were measured in cephalograms. Eight ROC curves were plotted (I vs II, and I vs III for each one of the variables). The area under the curve was measured and compared (Ji-square test). Cut points were established. Results: To discriminate Class I from II, ANB showed the largest area under the curve (AUC) (0.876) and the cut point (best sensitivity and specificity) was at 5.75°. To discriminate class I from III, Wits showed the largest AUC (0.874) with a cut point of-3.25 mm. There were no statistical differences between the AUC for the four variables (p=0.48 y p=0.38 for class I-II and I-III). Conclusion: ANB and Wits performed better for the diagnosis of class II and III, respectively. Cut points in children were different from those reported in adults.

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