# TeleMed: Comparison of cervical intraepithelial neoplasia 2/3 treatment outcomes with a portable LMIC-adapted thermal ablation device vs. gas-based cryotherapy

> **NIH NIH R01** · CLEVELAND CLINIC LERNER COM-CWRU · 2021 · $161,305

## Abstract

Project Summary
The COVID-19 pandemic has resulted in the interruption of routine and non-emergency care around the world,
including cancer screening. In high-income countries, telemedicine has mitigated the impact of these
disruptions. In low- and middle-income countries (LMICs), however, the widespread use of telemedicine faces
significant barriers, including high costs and lack of technical expertise and regulatory guidance. At the same
time, the pandemic has provided the impetus for introducing telemedicine approaches that can be
implemented using existing infrastructure. In El Salvador, the Ministry of Health (MOH) has implemented a
COVID-19 result delivery method based on mobile phone text messaging. This Supplement will pilot a similar
result delivery strategy for cervical cancer screening and compare its performance to the current method of in-
person visits to health clinics. This complements parent grant (R01CA218195) in utilizing technological
innovation to increase access to cervical cancer prevention services in LMICs.
Currently, approximately 40% of screen-negative women and 20% of screen-positive women do not receive
their cervical cancer screening results. We will develop a pilot telemedicine intervention to communicate results
to patients in the Paracentral region of El Salvador. We will use a commercially available automated texting
service (Twilio Inc., San Francisco, CA) and embed it in a patient database created in collaboration with the
country's Cancer Unit at the MOH. A comparative cross-sectional study will compare the telemedicine
intervention against the current result delivery model. A group of 550 women will be assigned to the
intervention. Screen-negative patients will be informed of their results and given recommendations for future
screenings. Screen-positive women will receive a message directing them to call their assigned local health
clinic to schedule an appointment to receive their results. In the control group, 550 women will be asked to
return to the clinic 30 days after screening to receive their results in person, both positive or negative, as per
current practice. Women in both groups will be administered a brief acceptability questionnaire to assess
perceptions and attitudes of the delivery method. Program-level indicators for clinics assigned to intervention
and control groups will also be collected. We hypothesize that the telemedicine intervention will allow more
women to receive their results in a shorter time period and result in increased adherence to follow-up services.

## Key facts

- **NIH application ID:** 10380329
- **Project number:** 3R01CA218195-04S2
- **Recipient organization:** CLEVELAND CLINIC LERNER COM-CWRU
- **Principal Investigator:** Karla Alfaro
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $161,305
- **Award type:** 3
- **Project period:** 2018-01-12 → 2023-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10380329

## Citation

> US National Institutes of Health, RePORTER application 10380329, TeleMed: Comparison of cervical intraepithelial neoplasia 2/3 treatment outcomes with a portable LMIC-adapted thermal ablation device vs. gas-based cryotherapy (3R01CA218195-04S2). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10380329. Licensed CC0.

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