Diagnostic Value of Amsel's Clinical Criteria for Diagnosis of Bacterial Vaginosis

Abstract

Introduction:Bacterial vaginosis (BV) is one of the most prevalent infections in women of reproductive age. Amsel’s criteria and Nugent scoring system are among the most commonly used diagnostic methods. Although Nugent scoring system is considered the gold standard for diagnosing BV, it is time consuming and costly, and its interpretation needs lab equipment and experts. Hence, most physicians are inclined to use simpler clinical criteria that are yet accurate instead. The present study aimed to determine the diagnostic value of Amsel’s criteria in diagnosing BV.Material and Methods:This present study was conducted to validate diagnostic tests of BV in 120 married women in 2013. Amsel’s criteria and Nugent scoring system were used to diagnose BV. Nugent scoring system was considered the gold standard and sensitivity, specificity, positive predictive value and negative predictive value of Amsel’s criteria were compared with those of Nugent scoring system.Results:Kappa coefficient was used to assess the diagnostic value of Nugent scoring system and Amsel’s criteria. Kappa coefficient was found 0.8, which confirms the reliability of both diagnostic methods. McNemar test did not reveal a significant difference between Nugent scoring system and Amsel’s criteria in terms of diagnosing BV. As compared to Nugent scoring system, Asmel’s criteria enjoy sensitivity of 0.91, specificity of 0.91, positive predictive value of 0.86, negative predictive value of 0.94, and accuracy of 0.91.Conclusion:If lab equipment is not available for diagnosing BV, Amsel’s criteria can be as good as Nugent scoring system at diagnosing this infection.

Prevalence and risk factors for bacterial vaginosis in sexually active females in age group 20-45 years and comparison of Amsel's criteria with Nugent's score

“…And Amsel criteria could be as good as Nugent scoring system at diagnosing this infection. 14 In present study authors considered Nugent's criteria as gold standard and found that Amsel's criteria had positive predictive value = 88.88%, negative predictive value = 79.67%, sensitivity = 71.11% and specificity = 92.73%.…”

Metatranscriptome Analysis of the Vaginal Microbiota Reveals Potential Mechanisms for Protection against Metronidazole in Bacterial Vaginosis

“…These four patients all received the commercially available lactic acid pessary after metronidazole therapy at visit 3 and visit 4. A Nugent score of >6 was used to determine BV status since it is considered the gold standard for BV diagnosis ( 55 ) (see Data Set S1 , sheet 1, in the supplemental material). The BV status at visit 5 was determined by Amsel criteria as there was no Nugent score available at that time point.…”

Diagnosis of Bacterial Vaginosis among Symptomatic Egyptian Women: Value of Assessing Bacterial Sialidase Activity

“…Closely related results were obtained by Gad et al, (2014) who found that Amsel's criteria had a sensitivity of 88% and a specificity of 89.6% for the diagnosis of BV compared to the Nugent score. However, higher sensitivity (91% and 91%) and specificity (99% and 91%) for Amsel's criteria were reported by Bradshaw et al, (2005) and Mohammadzadeh et al, (2015), respectively. On the other hand, in the studies of Beverly et al, (2005), Dadhwal et al, (2010), Modak et al, (2011), Khatoon et al, (2013) and Taj et al, (2014), a much lower sensitivity (37%, 51.2%, 66.7%, 69%, and 68.3% respectively) with a higher specificity (99%, 98%, 94.7%, 93.1%, and 97.1% respectively) were reported.…”