Derivation and validation of a clinical diagnostic model for chlamydial cervical infection in university women.
We developed and prospectively tested a logistic regression model for chlamydial cervical infection. Study subjects included 2271 women receiving gynecologic care in our student health clinic. Clinical data were collected in a standardized fashion. We identified cell culture--isolated Chlamydia trachomatis from 133 (9%) of 1458 subjects in the derivation set and 73 (10%) of 729 subjects in the validation set. Model variables included a new sexual partner within 2 months or more than one sexual partner within 6 months; cervical ectopy; cervical friability; at least 20 polymorphonuclear leukocytes per high-power field in cervical secretions; white blood cells in vaginal secretions; and use of an antibiotic active against C trachomatis within a month. This model can distinguish women with low, medium, and high risks of chlamydial infection (on derivation set: receiver operating characteristic curve area, 0.710; SE, 0.026; on validation set: area, 0.698; SE, 0.035) using simple clinical information obtained in the office.
Johnson
B A
BA
Department of Internal Medicine, Medical College of Virginia, Virginia Commonwealth University, Richmond.
Poses
R M
RM
Fortner
C A
CA
Meier
F A
FA
Dalton
H P
HP
D000293:Adolescent; D000328:Adult; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000382:microbiology; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D016015:Logistic Models; D009504:Neutrophils; D011446:Prospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012725:Sexual Behavior; D013334:Students; D002575:Uterine Cervicitis / Q000175:diagnosis* / Q000382:microbiology; D014626:Vaginal Smears