The Accuracy of Women Performing Vaginal pH Self-Testing

Kulp, Jennifer L.; Chaudhry, Sonal; Wiita, Brinda; Bachmann, Gloria

doi:10.1089/jwh.2007.0446

Cited by 7 publications

(3 citation statements)

References 16 publications

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“…19 A number of studies have either questioned the role of infectious agents in chronic vaginal symptoms 20 or pointed to the importance of psychosocial factors in the etiology of vaginal symptoms. [21][22][23] Researchers in the field are exploring protocols based on pH testing, 17,24 selfcollection of samples, 25 and more accurate tests such as polymerase chain reactions. 26 It is also possible that vaginal symptoms often represent selflimited conditions.…”

Section: Discussionmentioning

confidence: 99%

Are a Speculum Examination and Wet Mount Always Necessary for Patients With Vaginal Symptoms? A Pilot Randomized Controlled Trial

Anderson¹,

Cohrssen²,

Klink³

et al. 2009

The Journal of the American Board of Family Medicine

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Purpose:The suggested evaluation of vaginal symptoms is based on the wet mount diagnosis of candidiasis, trichomoniasis, and bacterial vaginosis. We wondered if patients with vaginal symptoms could be managed initially based solely on symptoms.Methods: This pilot randomized controlled trial was conducted in 2 urban family practice clinics and enrolled 46 premenopausal, nonpregnant women with acute vaginal symptoms. In the control arm, women were managed based on a speculum examination and wet mount. In the intervention arm, women were managed based on symptoms. Women were tested for gonorrhea, chlamydia, and trichomoniasis and called 2 weeks later to assess symptom resolution, adverse medication effects, need for revisit, and satisfaction with care.Results: Forty-one of 44 women (93%) felt better 2 weeks after the visit; 28 (64%) had complete resolution of symptoms. The intervention arm had slightly better resolution of symptoms (P ‫؍‬ .046); there were other no differences between the 2 arms. Three women were diagnosed with sexually transmitted diseases (trichomoniasis, chlamydia, and gonorrhea).Conclusions: Our pilot study suggests that in selected women it may be reasonable to initially manage vaginal complaints based on symptoms. These results should be confirmed in other larger trials. Vaginal symptoms are extremely common in women presenting to primary care settings and are considered among the most common reasons women consult with physicians.1,2 The current standard of care for vaginal symptoms focuses on diagnosing bacterial vaginosis, trichomoniasis, and vaginal candidiasis using evaluation of the discharge with microscopy, pH testing, and the whiff test.3-5 Although theoretically it makes sense to diagnose before treatment, the actual benefit of following this approach has not been demonstrated in a clinical trial. There are both theoretical and practical problems with an approach to vaginal symptoms that focuses on identifying bacterial vaginosis, trichomoniasis, and candidiasis. First, the differential diagnosis of vaginal complaints is broad, including not only other microbial causes (herpes simplex, cervicitis, urinary tract infection) but also dermatologic conditions (desquamative inflammatory vaginitis, lichen simplex); vulvodynia; and concerns about sexual dysfunction and abuse. Secondly, studies in a wide variety of clinical settings show that no cause is identified in 25% to 50% of women with vaginal symptoms. 6 -8 This suggests that at least some women may present because of excessive physiologic discharge. Further complicating the picture, candida and trichomonas are often isolated from asymptomatic women, 9,10 so it is difficult to distinguish symptomatic infection from mere colo-

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Section: Discussionmentioning

confidence: 99%

Are a Speculum Examination and Wet Mount Always Necessary for Patients With Vaginal Symptoms? A Pilot Randomized Controlled Trial

Anderson¹,

Cohrssen²,

Klink³

et al. 2009

The Journal of the American Board of Family Medicine

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show abstract

“…Consumer testing for vaginal pH measurement has been developed and FDA approved for OTC use. Several studies have demonstrated that women were able to self-collect samples and understand package directions (Roy, Caillouette, Faden, & Roy, 2005), that women's interpretation of testing results correlated with physician readings (Kulp, Chaudhry, Wiita, & Bachmann, 2008;Strauss, 2005). According to Nyirjesy and Sobel (2005), the use of the pH testing enhances women's self-diagnostic abilities and could decrease inappropriate antifungal treatment by women in 50 percent of cases.…”

Section: Self-diagnosismentioning

confidence: 99%

Women's Self-Diagnostic Skills: Developing the Science

Theroux¹

2010

Nursing for Women's Health

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“…In a study on self-reading of skin reactions following chickenpox vaccination, a 90% agreement was found, and the procedure was stated to be usable for routine vaccination assessment [20]. Other examples where self-reporting by patients have been found to be reliable are reading of a patch test for nickel allergy [21], scoring of hand eczema [22], and self-assessment of vaginal pH measurement [23,24]. In some medical fields, a more advanced progress in terms of self-reading has developed, for example self-reporting of blood pressure in patients with hypertension, for which implementation of the procedure has been reported to lead to increased use and reinforced preventive benefits [25,26].…”

Section: Introductionmentioning

confidence: 99%

Patient Performed Reading of a Phototest - A Reliable Method?

Thorslund¹,

Falk²

2012

J. Anal. Oncol.

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In various situations, in clinical practice or for prevention purposes directed at skin cancer, a broadened use of phototesting to estimate individual skin UV-sensitivity may be warranted. The aim of the present study was to investigate, in a primary health care population, the reliability of patient performed reading of a UVB phototest, when compared to the reading of a trained physician. Thirty-two subjects, all patients recruited in a primary health care population, underwent a UVB phototest, applied on the forearm. Test reading was performed after 24 hours, by the subjects themselves, by counting the number of erythemal reactions (0-6) detectable, and immediately after this, an independent control reading performed by a doctor was also done. The results showed a 72% absolute agreement between the subjects' readings and the control readings, and with a weighted kappa-value of 0.78 (95 CI: 0.64-0.91), i.e. corresponding to "substantial agreement". In conclusion, patient performed self-reading of a UVB phototest appears to be a fairly reliable method for estimation of individual skin UV-sensitivity, when compared to the reading of a trained observer. The finding opens up for a broadened use of phototesting in clinical practice and for preventive initiatives aiming at identifying at-risk individuals and reducing sun exposure.

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The Accuracy of Women Performing Vaginal pH Self-Testing

Abstract: Study participants could accurately measure vaginal pH through self-testing. Vaginal pH self-testing may be a convenient tool to help women determine whether they should use an over-the-counter (OTC) antifungal medication or go to a physician for diagnostic workup.

Cited by 7 publications

References 16 publications

Are a Speculum Examination and Wet Mount Always Necessary for Patients With Vaginal Symptoms? A Pilot Randomized Controlled Trial

Are a Speculum Examination and Wet Mount Always Necessary for Patients With Vaginal Symptoms? A Pilot Randomized Controlled Trial

Women's Self-Diagnostic Skills: Developing the Science

Patient Performed Reading of a Phototest - A Reliable Method?

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