The accuracy of clinical findings and laparoscopy in pelvic inflammatory disease
| Autor: | Barry Hunter, James B. Mahony, Darlyne J. Rath, Harry Richardson, David Groves, John W. Sellors, Rajinder Mander, Charles H. Goldsmith, Clifford R. Taylor, Max Chernesky |
|---|---|
| Rok vydání: | 1991 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Cervix Uteri Salpingitis Pregnancy Laparotomy Positive predicative value Biopsy Pelvic inflammatory disease medicine Humans Diagnostic Errors Laparoscopy Gynecology medicine.diagnostic_test business.industry Pelvic pain Obstetrics and Gynecology medicine.disease Pregnancy Ectopic Female Radiology medicine.symptom business Contraceptives Oral Forecasting Pelvic Inflammatory Disease Endometrial biopsy |
| Zdroj: | American Journal of Obstetrics and Gynecology. 164:113-120 |
| ISSN: | 0002-9378 |
| DOI: | 10.1016/0002-9378(91)90639-9 |
| Popis: | The accuracy of clinical diagnosis for pelvic inflammatory disease was determined in 95 women who presented with pelvic pain to primary care physicians and then were referred to gynecologists. Laparoscopy or laparotomy with endometrial biopsy and fimbrial minibiopsy revealed that prevalence of pelvic inflammatory was 46% (44/95) and positive and negative predictive values of gynecologists were 74% (23/31) and 67% (43/64) (p = 0.0002). If histopathologic diagnosis was the standard, clinical accuracies of the gynecologists were no better than chance (p = 0.43), suggesting an expectation bias for visual diagnosis. Laparoscopy had a sensitivity of 50% (12/24) and a specificity of 80% (40/50) for salpingitis if the standard was fimbrial histopathologic diagnosis (p = 0.01). These results support the routine use of laparoscopy, supplemented when negative by endometrial and fimbrial minibiopsy, to accurately diagnose pelvic inflammatory disease. |
| Databáze: | OpenAIRE |
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