ArticleSexually transmitted infections2003
LCR testing for gonorrhoea and chlamydia in population surveys and other screenings of low prevalence populations: coping with decreased positive predictive value.
Article in Sexually transmitted infections, 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 43 citations in OpenAlex.
- Detection Algorithms for Gastrointestinal Perforation Cases in the Medical Information Database Network (MID-NETTherapeutic innovation & regulatory science · 2024Article
- Molecular diagnostics for gonorrhoea: implications for antimicrobial resistance and the threat of untreatable gonorrhoea.PLoS medicine · 2014Review
- Epidemiology of undiagnosed trichomoniasis in a probability sample of urban young adults.PloS one · 2014Article
- Gender-based screening for chlamydial infection and divergent infection trends in men and women.PloS one · 2014Article
- Nucleic Acid Amplification of the opa Gene for Detection of Neisseria gonorrhoeae: experience from a diagnostic laboratory.Journal of clinical microbiology · 2011Article
- The epidemiology of gonorrhoea in Norway, 1993-2007: past victories, future challenges.BMC infectious diseases · 2009Article
- Neisseria species identification assay for the confirmation of Neisseria gonorrhoeae-positive results of the COBAS Amplicor PCR.Journal of clinical microbiology · 2007Article
- Asymptomatic men: should they be tested for urethritis?Sexually transmitted infections · 2007Article
- Prevalence and risk factors of chlamydia and gonorrhea among rural Nepali women.Sexually transmitted infections · 2005Article
- Enhanced enzyme immunoassay with negative-gray-zone testing compared to a single nucleic Acid amplification technique for community-based chlamydial screening of men.Journal of clinical microbiology · 2005Article
- Gonorrhea Update.Current infectious disease reports · 2004Article
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5 authors at 1 institution in 1 country.
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Abstract
objectiveNucleic acid amplification tests have facilitated field based STD studies and increased screening activities. However, even with highly specific tests, the positive predictive value (PPV) of such tests may be lower than desirable in low prevalence populations. We estimated PPVs for a single LCR test in a population survey in which positive specimens were retested.
methodsThe Baltimore STD and Behavior Survey (BSBS) was a population based behavioural survey of adults which included collecting urine specimens to assess the prevalence of gonorrhoea and chlamydial infection. Gonorrhoea and chlamydial infection were diagnosed by ligase chain reaction (LCR). Nearly all positive results were retested by LCR. Because of cost considerations, negative results were not confirmed. Predicted curves for the PPV were calculated for a single testing assuming an LCR test sensitivity of 95%, and test specificities in the range 95.0%-99.9%, for disease prevalences between 1% and 10%. Positive specimens were retested to derive empirical estimates of the PPV of a positive result on a single LCR test.
results579 participants age 18-35 provided urine specimens. 20 (3.5%) subjects initially tested positive for chlamydial infection, and 39 (6.7%) tested positive for gonococcal infection. If positive results on the repeat LCR are taken as confirmation of a "true" infection, the observed PPV for the first LCR testing was 89.5% for chlamydial infection and 83.3% for gonorrhoea. This is within the range of theoretical PPVs calculated from the assumed sensitivities and specificities of the LCR assays.
conclusionsEmpirical performance of a single LCR testing approximated the theoretically predicted PPV in this field study. This result demonstrates the need to take account of the lower PPVs obtained when such tests are used in field studies or clinical screening of low prevalence populations. Repeat testing of specimens, preferably with a different assay (for example, polymerase chain reaction), and disclosure of the non-trivial potential for false positive test results would seem appropriate in all such studies.
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