Missing pelvic inflammatory disease? Substantial differences in the rate at which doctors diagnose PID

Sexually Transmitted Infections
A DoxanakisC K Fairley

Abstract

The clinical diagnosis of pelvic inflammatory disease (PID) is subjective. Our aim was to determine if the pattern of diagnosis of PID among experienced clinicians varied compared with the diagnosis of genital warts. We conducted a retrospective study of 325 PID diagnoses made by experienced clinicians at Melbourne Sexual Health Centre, Australia (2002-2006), where doctors saw 21 785 unselected female patients in a walk-in service. We compared the proportion of female patients diagnosed as having PID and genital warts between doctors and then compared doctors above (high diagnosing) and below (low diagnosing) the mean rate of PID diagnosis. There were significant and clinically important differences in the proportion of women diagnosed with having PID (0-5.7%) across 23 doctors investigated. Estimated standard deviation in the frequency of PID diagnosis (logit scale) was 1.26 (95% CI 0.81 to 1.95)--approximately four times greater than for warts. Patients seen by high (n = 4673) and low (n = 16 787) diagnosing doctors had similar epidemiological risk profiles suggesting true distribution of PID cases across doctors was similar (p>0.13). Women diagnosed with having PID by high diagnosing doctors compared with low diagnosing doct...Continue Reading

Citations

Oct 5, 2010·The British Journal of General Practice : the Journal of the Royal College of General Practitioners·Amanda NicholsonJackie Cassell
Sep 14, 2012·Infectious Diseases in Obstetrics and Gynecology·Bette LiuRebecca Guy
Sep 6, 2015·Women's Health Issues : Official Publication of the Jacobs Institute of Women's Health·Misty PachecoJay E Maddock
Sep 18, 2009·International Journal of STD & AIDS·D Taylor-RobinsonP E Munday
Dec 13, 2012·The Medical Journal of Australia·Christopher K Fairley, Jane S Hocking
Dec 13, 2012·The Medical Journal of Australia·Bronwyn J SilverAlice R Rumbold

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