Title	ViziLite As An Aid To Oral Cancer Detection and Diagnosis
Clinical Question	How does ViziLite compare to conventional oral screening and surgical biopsy in identifying pre-cancerous and cancerous lesions?
Clinical Bottom Line	ViziLite provides little assistance to the detection and diagnosis of pre-cancerous and cancerous lesions beyond conventional oral screening alone.
Best Evidence
PubMed ID Author / Year Patient Group Study type (level of evidence) 21615500 Awan / 2011 126 patients with red, white, or mixed oral patches Clinical trial (blinded) Key results ViziLite is unable to discriminate between dysplastic and non-dysplastic lesions (Sensitivity: 77.3% and Specificity: 27.8%). The high rate of false positives may contribute to unnecessary referrals or biopsies. The predictive values (PPV: 56.8% and NPV: 48.4%) are not applicable due to the low prevalence of oral potentially malignant disorders. 20123872 Mehrotra / 2010 102 patients with clinically innocuous oral lesions Cross-Sectional (blinded) Key results (Sensitivity: 0%, Specificity: 75.5%, PPV: 0%, NPV: 94.8%) The high rate of false-negatives may contribute to undetected and undiagnosed pre-cancerous and cancerous lesions leading to an increase in the diagnosis of advanced oral cancers. ViziLite more readily identifies leukoplakias than clinically innocuous lesions.
Evidence Search	Diagnosis/Broad[filter] AND Vizilite[All Fields]
Comments on The Evidence	In both studies, ViziLite was blinded to the gold standard of oral cancer detection and diagnosis (conventional oral examination under incandescent lighting and surgical biopsy). Differences in the spectrum of disease severity are noted between the Awan study (red, white, or mixed oral patches) and the Mehrotra study (clinically innocuous oral lesions).
Applicability	ViziLite is incapable of distinguishing benign from dysplastic or cancerous oral lesions. There is insufficient evidence that ViziLite improves the identification of oral lesions over using conventional methods alone. Both articles indicate the need for further studies on the utility of Vizilite in the general dental practice setting.
Specialty	(Public Health) (Oral Medicine/Pathology/Radiology) (General Dentistry) (Oral Surgery)
Keywords	Oral cancer, Oral dysplasia, Detection, Diagnosis
ID#	2195
Date of submission	04/13/2012
E-mail	nikmard@livemail.uthscsa.edu
Author	B. John Nikmard
Co-author(s)
Co-author(s) e-mail
Faculty mentor	Edward Ellis, III, DDS
Faculty mentor e-mail	ellise3@uthscsa.edu
Basic Science Rationale (Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) None available
Comments and Evidence-Based Updates on the CAT (FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) by Alysia Nicholson, Daniel Chitty (San Antonio, Texas) on 11/28/2017 A PubMed database search was conducted in November 2017. A study published in 2016 by Nagi et. al. (PMID #26946209) involved a systematic review of 10 studies using ViziLite and other early detection devices. The results included: 77.1% - 100% sensitivity and 0% - 27.8% specificity for Vizilite; the articles in the published CAT reported similar values for sensitivity and specificity. Furthermore, it was only found to be useful clinically for detecting leukoplakia, not erythroplakia. Therefore, this article does not significantly change the previously published answer, but rather it supports the conclusions of the CAT .