average article

via and vili  helps in deciding the site of biopsy wher colposcopy is not available.

The paper subject is useful and would be more informative if the applicability of the results were demonstrated in a population with an elevated prevalence of cervical cancer or cervical intraepithelial neoplasia (e.g. Indian women) using a 2x2 table and calculating the positive predictive and negative predictive values of the less expensive test (VIA/VILI) compared with the gold standard test (cytology) in that specific population.

Please add "Results" section to the body of the paper and illustrative pictures of the VIA/VILI test. Also, expand the discussion if possible and provide conclusion and recommendations at the end of the paper.

OBGYN

Would add a arm looking at via/vili directed biopsy with ecc compared with colposcopic and cytologic findings as this would allow futher local screening without referal and might further reduce cost. Sadly when economics control the ability of women to be screened for  the scouge of CVX Ca some effective screening is better than  none and will vastly deminish the risk of undiagnosed advanced CIN and CVX cancer. The negative bx group could be triaged to cytology and if negative remain inlocal follow up and the positive bxs with high grade disease could be treated localy without referral by cone or leep if feasible at minimal level health  care centers leaving only the equivical cases to be referred for colposcopic evaluation and repeated cytoloy.

Used vili in medical school to dirct biopsy without colposcopy many years ago still use it as a usefull adjunct to colposcopy with  acetic acid especially in Vain case more than thirty years later.