Open AccessThe Clinical Diagnosis of Urethral Discharge
Author(s) -
Richard Rothenberg,
Franklyn N. Judson
Publication year - 1983
Publication title -
sexually transmitted diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.507
H-Index - 105
eISSN - 1537-4521
pISSN - 0148-5717
DOI - 10.1097/00007435-198301000-00005
Subject(s) - medicine , gonorrhea , false positive paradox , grading (engineering) , urethra , urethritis , family medicine , surgery , statistics , human immunodeficiency virus (hiv) , engineering , civil engineering , mathematics
When a standard method for grading urethral discharge that is based on quantity (profuse, moderate, or scant) and quality (purulent, cloudy, or clear) is used, the optimal performance of the clinical diagnosis of gonorrhea is 73%. This performance (true positives over true plus false positives) is dependent not only on the sensitivity, specificity, and prevalence of gonorrhea but also on the components of that prevalence, i.e., the specific mix of patients who attend a clinical service. Optimal performance, as determined through use of a relative operating characteristics curve, will vary from setting to setting depending upon certain patient variables, such as race and sexual preference. Clinics with full diagnostic service would not employ clinical diagnosis as a screening tool directly, but rather as an epidemiologic device for helping to characterize patient populations at risk. Areas with less developed clinic facilities might apply these observations for clinical decision making in the absence of laboratory support.