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Table 1.

Overview of studies included in meta-analysis BV – CIN.

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Table 2.

Overview of Dutch studies using the KOPAC system.

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Figure 1.

Study selection flowchart for meta-analysis BV – CIN.

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Figure 2.

Box plots showing the difference in BV prevalence depending on BV diagnostic criteria (Amsel, Clue cells only and Nugent).

Comparison between data distribution (box plots) and estimated average (full vertical line).

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Figure 3.

Forest plot of studies included in meta-analysis BV – CIN.

Each study is represented by a black square and a horizontal line, which corresponds to the odds ratio (OR) and its symmetric 95% confidence interval (CI). The area of the square reflects the weight each study contributes to the meta-analysis. The diamond at the bottom of the graph represents the combined OR and its 95% CI, calculated using a random effects model. The solid vertical line corresponds to no association (OR 1.0), the dotted vertical line to the combined OR (1.51). The OR (or estimates ES), 95% CI and weights are also given in tabular form.

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Figure 4.

Box plots according to BV diagnostic criteria and study population.

Each box plot represents a summary of 5 data: 25th and 75th percentile or inter-quartile range of the data (left and right edge of box, respectively), the median (vertical band near the middle of the box), the minimum and maximum data value (ends of horizontal lines or whiskers). Full horizontal lines represent OR and its 95% CI according to BV diagnosis (left) and stratified by study population (right), estimated by random effects regression model. Figure 4a: Difference in odds ratio (logarithmic scale) depending on BV diagnostic criteria: Clue cells only (one study using Modified Amsel, i.e. presence of clue cells and positive amine whiff test) versus more stringent criteria (strict), including Nugent and Amsel. Figure 4b: Difference in odds ratios (logarithmic scale) depending on study population, stratified as screened women and women with an indication smear (e.g. referred for colposcopy or obstetric/gynaecologic clinic attendees). Figure 4c: Difference in odds ratio (logarithmic scale) depending on CIN diagnostic criteria: Cytology versus Histology. Figure 4d: Difference in odds ration (logarithmic scale) depending on developing state of the country, stratified as developing and industrialized.

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