Prediction of pelvic inflammatory disease among young, single, sexually active women.
OBJECTIVE
To assess prediction strategies for pelvic inflammatory disease (PID).


METHODS
One thousand one hundred seventy women were enrolled based on a high chlamydial risk score. Incident PID over a median of 3 years was diagnosed by either histologic endometritis or Centers for Disease Control and Prevention criteria. A multivariable prediction model for PID was assessed.


RESULTS
Women enrolled using the risk score were young, single, sexually active, and often had prior sexually transmitted infections. Incident PID was common (8.6%). From 24 potential predictors, significant factors included age at first sex, gonococcal/chlamydial cervicitis, history of PID, family income, smoking, medroxyprogesterone acetate use, and sex with menses. The model correctly predicted 74% of incident PID; in validation models, correct prediction was only 69%.


CONCLUSIONS
Our data validate a modified chlamydial risk factor scoring system for prediction of PID. Additional multivariable modeling contributed little to prediction. Women identified by a threshold value on the chlamydial risk score should undergo intensive education and screening.
Ness
Roberta B
RB
Graduate School of Public Health, University of Pittsburgh, Pennsylvania 15261, USA. repro@pitt.edu
Smith
Kenneth J
KJ
Chang
Chung-Chou H
CC
Schisterman
Enrique F
EF
Bass
Debra C
DC
D000293:Adolescent; D000328:Adult; D002690:Chlamydia Infections / Q000175:diagnosis / Q000382:microbiology*; D005260:Female; D006801:Humans; D000292:Pelvic Inflammatory Disease / Q000175:diagnosis* / Q000382:microbiology; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012725:Sexual Behavior; D015231:Sexually Transmitted Diseases, Bacterial / Q000175:diagnosis / Q000382:microbiology*