Derivation and validation of a clinical diagnostic model for chlamydial cervical infection in university women

JAMA. 1990 Dec 26;264(24):3161-5.


We developed and prospectively tested a logistic regression model for chlamydial cervical infection. Study subjects included 2271 women receiving gynecologic care in our student health clinic. Clinical data were collected in a standardized fashion. We identified cell culture--isolated Chlamydia trachomatis from 133 (9%) of 1458 subjects in the derivation set and 73 (10%) of 729 subjects in the validation set. Model variables included a new sexual partner within 2 months or more than one sexual partner within 6 months; cervical ectopy; cervical friability; at least 20 polymorphonuclear leukocytes per high-power field in cervical secretions; white blood cells in vaginal secretions; and use of an antibiotic active against C trachomatis within a month. This model can distinguish women with low, medium, and high risks of chlamydial infection (on derivation set: receiver operating characteristic curve area, 0.710; SE, 0.026; on validation set: area, 0.698; SE, 0.035) using simple clinical information obtained in the office.

MeSH terms

  • Adolescent
  • Adult
  • Chlamydia Infections / diagnosis*
  • Chlamydia Infections / microbiology
  • Chlamydia trachomatis* / isolation & purification
  • Cross-Sectional Studies
  • Female
  • Humans
  • Leukocyte Count
  • Logistic Models
  • Neutrophils
  • Prospective Studies
  • Risk Factors
  • Sensitivity and Specificity
  • Sexual Behavior
  • Students
  • Uterine Cervicitis / diagnosis*
  • Uterine Cervicitis / microbiology
  • Vaginal Smears