The predictive value of medical history taking and Chlamydia IgG ELISA antibody testing (CAT) in the selection of subfertile women for diagnostic laparoscopy: A clinical prediction model approach

S F P J Coppus, B C Opmeer, Susan Logan, F van der Veen, Siladitya Bhattacharya, B W J Mol

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

BACKGROUND: Medical history taking as well as Chlamydia antibody titre (CAT) testing are currently used in the selection of patients for diagnostic laparoscopy with tubal patency testing. Most research has focused on the predictive value of CAT in isolation from medical history. We assessed therefore whether the combination of medical history and CAT improves the efficiency of selecting patients for laparoscopy as compared to the use of either medical history or CAT. METHODS: Data of 207 consecutive subfertile women were used to create multivariable logistic regression models for the prediction of tubal disease as diagnosed by diagnostic laparoscopy. RESULTS: The model with data of medical history only had an area under the receiver operating characteristic curve (AUC) of 0.65 (95% CI 0.56-0.74). Addition of CAT increased the AUC to 0.70 (95% CI 0.62-0.78) (P = 0.065). CAT was positive in 40 women and showed a sensitivity of 0.37 (95% CI 0.26-0.49) for a specificity of 0.88 (95% CI 0.82-0.93). In CAT positive women, a blank medical history did not decrease the probability of tubal disease. Of the 167 women tested CAT negative, 23 (14%) still had a high probability of disease due to their medical history and 11 of them (48%) showed tubal abnormalities on diagnostic laparoscopy. CONCLUSIONS: CAT testing adds valuable information to a woman's risk profile based on her medical history. The combination of medical history taking and CAT testing has a better yield for diagnosing tubal disease than either of these alone.
Original languageEnglish
Pages (from-to)1353-1358
Number of pages6
JournalHuman Reproduction
Volume22
Issue number5
DOIs
Publication statusPublished - 2007

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Medical History Taking
Chlamydia
Laparoscopy
Immunoglobulin G
Enzyme-Linked Immunosorbent Assay
Antibodies
Area Under Curve
Logistic Models
ROC Curve
Patient Selection

Keywords

  • adult
  • antibodies, bacterial
  • chlamydia trachomatis
  • enzyme-linked immunosorbent assay
  • fallopian tube diseases
  • female
  • humans
  • infertility, female
  • laparoscopy
  • medical history taking
  • predictive value of tests
  • ROC curve
  • sensitivity and specificity

Cite this

The predictive value of medical history taking and Chlamydia IgG ELISA antibody testing (CAT) in the selection of subfertile women for diagnostic laparoscopy : A clinical prediction model approach. / Coppus, S F P J; Opmeer, B C; Logan, Susan; van der Veen, F; Bhattacharya, Siladitya; Mol, B W J.

In: Human Reproduction, Vol. 22, No. 5, 2007, p. 1353-1358.

Research output: Contribution to journalArticle

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abstract = "BACKGROUND: Medical history taking as well as Chlamydia antibody titre (CAT) testing are currently used in the selection of patients for diagnostic laparoscopy with tubal patency testing. Most research has focused on the predictive value of CAT in isolation from medical history. We assessed therefore whether the combination of medical history and CAT improves the efficiency of selecting patients for laparoscopy as compared to the use of either medical history or CAT. METHODS: Data of 207 consecutive subfertile women were used to create multivariable logistic regression models for the prediction of tubal disease as diagnosed by diagnostic laparoscopy. RESULTS: The model with data of medical history only had an area under the receiver operating characteristic curve (AUC) of 0.65 (95{\%} CI 0.56-0.74). Addition of CAT increased the AUC to 0.70 (95{\%} CI 0.62-0.78) (P = 0.065). CAT was positive in 40 women and showed a sensitivity of 0.37 (95{\%} CI 0.26-0.49) for a specificity of 0.88 (95{\%} CI 0.82-0.93). In CAT positive women, a blank medical history did not decrease the probability of tubal disease. Of the 167 women tested CAT negative, 23 (14{\%}) still had a high probability of disease due to their medical history and 11 of them (48{\%}) showed tubal abnormalities on diagnostic laparoscopy. CONCLUSIONS: CAT testing adds valuable information to a woman's risk profile based on her medical history. The combination of medical history taking and CAT testing has a better yield for diagnosing tubal disease than either of these alone.",
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T1 - The predictive value of medical history taking and Chlamydia IgG ELISA antibody testing (CAT) in the selection of subfertile women for diagnostic laparoscopy

T2 - A clinical prediction model approach

AU - Coppus, S F P J

AU - Opmeer, B C

AU - Logan, Susan

AU - van der Veen, F

AU - Bhattacharya, Siladitya

AU - Mol, B W J

PY - 2007

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N2 - BACKGROUND: Medical history taking as well as Chlamydia antibody titre (CAT) testing are currently used in the selection of patients for diagnostic laparoscopy with tubal patency testing. Most research has focused on the predictive value of CAT in isolation from medical history. We assessed therefore whether the combination of medical history and CAT improves the efficiency of selecting patients for laparoscopy as compared to the use of either medical history or CAT. METHODS: Data of 207 consecutive subfertile women were used to create multivariable logistic regression models for the prediction of tubal disease as diagnosed by diagnostic laparoscopy. RESULTS: The model with data of medical history only had an area under the receiver operating characteristic curve (AUC) of 0.65 (95% CI 0.56-0.74). Addition of CAT increased the AUC to 0.70 (95% CI 0.62-0.78) (P = 0.065). CAT was positive in 40 women and showed a sensitivity of 0.37 (95% CI 0.26-0.49) for a specificity of 0.88 (95% CI 0.82-0.93). In CAT positive women, a blank medical history did not decrease the probability of tubal disease. Of the 167 women tested CAT negative, 23 (14%) still had a high probability of disease due to their medical history and 11 of them (48%) showed tubal abnormalities on diagnostic laparoscopy. CONCLUSIONS: CAT testing adds valuable information to a woman's risk profile based on her medical history. The combination of medical history taking and CAT testing has a better yield for diagnosing tubal disease than either of these alone.

AB - BACKGROUND: Medical history taking as well as Chlamydia antibody titre (CAT) testing are currently used in the selection of patients for diagnostic laparoscopy with tubal patency testing. Most research has focused on the predictive value of CAT in isolation from medical history. We assessed therefore whether the combination of medical history and CAT improves the efficiency of selecting patients for laparoscopy as compared to the use of either medical history or CAT. METHODS: Data of 207 consecutive subfertile women were used to create multivariable logistic regression models for the prediction of tubal disease as diagnosed by diagnostic laparoscopy. RESULTS: The model with data of medical history only had an area under the receiver operating characteristic curve (AUC) of 0.65 (95% CI 0.56-0.74). Addition of CAT increased the AUC to 0.70 (95% CI 0.62-0.78) (P = 0.065). CAT was positive in 40 women and showed a sensitivity of 0.37 (95% CI 0.26-0.49) for a specificity of 0.88 (95% CI 0.82-0.93). In CAT positive women, a blank medical history did not decrease the probability of tubal disease. Of the 167 women tested CAT negative, 23 (14%) still had a high probability of disease due to their medical history and 11 of them (48%) showed tubal abnormalities on diagnostic laparoscopy. CONCLUSIONS: CAT testing adds valuable information to a woman's risk profile based on her medical history. The combination of medical history taking and CAT testing has a better yield for diagnosing tubal disease than either of these alone.

KW - adult

KW - antibodies, bacterial

KW - chlamydia trachomatis

KW - enzyme-linked immunosorbent assay

KW - fallopian tube diseases

KW - female

KW - humans

KW - infertility, female

KW - laparoscopy

KW - medical history taking

KW - predictive value of tests

KW - ROC curve

KW - sensitivity and specificity

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DO - 10.1093/humrep/del521

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JO - Human Reproduction

JF - Human Reproduction

SN - 0268-1161

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ER -