No abstract

The sensitivity and specificity of tests to diagnose trichomoniasis vary widely.

Objective: To review critically and to summarize the evidence of diagnostic tests and culture media for the diagnosis of Trichomonas vaginitis.Methods: We performed a systematic review of literature indexed in MEDLINE of studies that used Trichomonas culture as the reference standard (9,882 patients, 35 studies). Level I studies (5,047 patients, 13 studies) fulfilled at least two of three criteria: 1) consecutive patients were evaluated prospectively, 2) decision to culture was not influenced by test results, and 3) there was independent and blind comparison to culture.Results: The sensitivity of the polymerase chain reaction technique (PCR) was 95% (95% CI 91% to 99%), and the specificity was 98% (95% CI 96% to 100%). One study was classified as Level I evidence (52 patients). The sensitivity of the enzyme-linked immunosorbent assay was 82% (95% CI 74% to 90%), and the specificity was 73% (95% CI 35% to 100%). The sensitivity of the direct fluorescence antibody was 85% (95% CI 79% to 90%), and the specificity was 99% (95% CI 98% to 100%). Sensitivities of culture media were 95% for Diamond's, 96% for Hollander, and 95% for CPLM.Conclusions: The sensitivity and specificity of tests to diagnose trichomoniasis vary widely. Infect.

Objective: To review critically and to summarize the evidence of diagnostic tests and culture media for the diagnosis of Trichomonas vaginitis.Methods: We performed a systematic review of literature indexed in MEDLINE of studies that used Trichomonas culture as the reference standard (9,882 patients, 35 studies). Level I studies (5,047 patients, 13 studies) fulfilled at least two of three criteria: 1) consecutive patients were evaluated prospectively, 2) decision to culture was not influenced by test results, and 3) there was independent and blind comparison to culture.Results: The sensitivity of the polymerase chain reaction technique (PCR) was 95% (95% CI 91% to 99%), and the specificity was 98% (95% CI 96% to 100%). One study was classified as Level I evidence (52 patients). The sensitivity of the enzyme-linked immunosorbent assay was 82% (95% CI 74% to 90%), and the specificity was 73% (95% CI 35% to 100%). The sensitivity of the direct fluorescence antibody was 85% (95% CI 79% to 90%), and the specificity was 99% (95% CI 98% to 100%). Sensitivities of culture media were 95% for Diamond's, 96% for Hollander, and 95% for CPLM.Conclusions: The sensitivity and specificity of tests to diagnose trichomoniasis vary widely. Infect.

OBJECTIVE:To evaluate the quality and concordance of methodologic criteria in abstracts versus articles regarding the diagnosis of trichomoniasis.STUDY DESIGN: Survey of published literature. DATA SOURCES: Studies indexed in MEDLINE (1976-1998).STUDY SELECTION: Studies that used culture as the gold or reference standard. DATA EXTRACTION:Data from abstract and articles were independently abstracted using 4 methodologic criteria: (1) prospective evaluation of consecutive patients; (2) test results did not influence the decision to do gold standard; (3) independent and blind comparison with gold standard; and (4) broad spectrum of patients used. The total number of criteria met for each report was calculated to create a quality score (0-4). MEASUREMENTS AND MAIN RESULTS:None of the 33 abstracts or full articles reported all 4 criteria. Three criteria were reported in none of the abstracts and in 18% of articles (95% confidence interval [95% CI] 8.6% to 34%). Two criteria were reported in 18% of abstracts (95% CI, 8.6% to 34%) and 42% of articles (95% CI, 27% to 59%). One criterion was reported in 42% of abstracts (95% CI, 27% to 59%) and 27% of articles (95% CI, 15% to 44%). No criteria were reported in 13 (39%) of 33 abstracts (95% CI, 25% to 56%) and 4 (12%) of 33 articles (95% CI, 4.8% to 27%). The agreement of the criteria between the abstract and the article was poor ( Ϫ 0.09; 95% CI, Ϫ 0.18 to 0) to moderate ( 0.53; 95% CI, 0.22 to 0.83). CONCLUSIONS:Information on methods basic to study validity is often absent from both abstract and paper. The concordance of such criteria between the abstract and article needs to improve. W hen faced with clinical questions regarding which is the best treatment for a patient or which diagnostic test is worth performing, physicians are being encouraged to look for evidence rather than rely solely on clinical experience or "expert" opinion. Although some clinical questions have no supporting data, it is felt that the quality of care would be improved if physicians used the "best available evidence" in making decisions. 1,2 One of the major barriers is the time required to find, read, evaluate, and understand the evidence. 3 The abstract is an important element in the communication from scientists to practitioners. High-quality abstracts reliably and succinctly reflect an article's methodology and content. The abstract provides enough information to allow readers to accurately assess if the article is relevant to their interests, has findings that could affect their practice, and uses methods that meet basic validity standards. The role of the abstract is as valuable to clinicians when it correctly directs them not to read an article as when it encourages reading a relevant article. Structured abstracts require authors to be explicit as to the design and findings described in the article and are used in journals to facilitate the communication of research findings. [4][5][6] In comparison with unstructured abstracts, some authors have shown that structured abstracts improve th...