title: Evaluation of a surveillance case definition for anogenital warts, Kaiser Permanente northwest.
abstract: BACKGROUND
  Most studies of anogenital wart (AGW) epidemiology have used large clinical or administrative databases and unconfirmed case definitions based on combinations of diagnosis and procedure codes.
  
  
  METHODS
  We developed and validated an AGW case definition using a combination of diagnosis codes and other information available in the electronic medical record (provider type, laboratory testing). We calculated the positive predictive value (PPV) of this case definition compared with manual medical record review in a random sample of 250 cases. Using this case definition, we calculated the annual age- and sex-stratified prevalence of AGW among individuals 11 through 30 years of age from 2000 through 2005.
  
  
  RESULTS
  We identified 2730 individuals who met the case definition. The PPV of the case definition was 82%, and the average annual prevalence was 4.16 per 1000. Prevalence of AGW was higher in females compared with males in every age group, with the exception of the 27- to 30-year-olds. Among females, prevalence peaked in the 19- to 22-year-olds, and among males, the peak was observed in 23- to 26-year-olds.
  
  
  CONCLUSIONS
  The case definition developed in this study is the first to be validated with medical record review and has a good PPV for the detection of AGW. The prevalence rates observed in this study were higher than other published rates, but the age- and sex-specific patterns observed were consistent with previous reports.
authors.affiliation: From the *The Center for Health Research, Kaiser Permanente Northwest, Portland, OR; and †Immunization Safety Office and ‡Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: Allison L
authors.initials: AL
authors.lastname: Naleway
authors.forename: Sheila
authors.initials: S
authors.lastname: Weinmann
authors.forename: Brad
authors.initials: B
authors.lastname: Crane
authors.forename: Julianne
authors.initials: J
authors.lastname: Gee
authors.forename: Lauri E
authors.initials: LE
authors.lastname: Markowitz
authors.forename: Eileen F
authors.initials: EF
authors.lastname: Dunne
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002985:Clinical Protocols; D003218:Condylomata Acuminata / Q000453:epidemiology* / Q000517:prevention & control; D016208:Databases, Factual; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D009922:Oregon / Q000453:epidemiology; D027383:Papillomaviridae / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000517:prevention & control; D053918:Papillomavirus Vaccines; D018571:Sentinel Surveillance
chemical_list: D053918:Papillomavirus Vaccines