Pelvic Inflammatory Disease: Likelihood Ratios

Introduction: Infection of the internal female genital organs.

50% from Chlamydia trachomatis. Others: Neisseria gonorrheae, mycoplasma, etc.

The likelihood ratios of findings for Pelvic Inflammatory Disease are listed below. See the left navigation bar to change the display.

Pre-Test Probability (Prevalence): %.	Post-Test Probability (Predictive Value): %.	Switch to display mode.
Note that calculating probabilities from more than one** finding is inherently inaccurate because findings are not independent. (For example, using two positive findings that share a common pathogenesis is likely to overestimate the true probability.)

Good Positive and Negative Likelihood Ratios
Finding	Result	+LR	-LR
[ + ] Abdominal MRI	+ 0 -	13.6	0.1
note: small series Study: J Infect. 2000 Jan;40(1):31-41. PMID: 10762109
[ + ] Nuclear WBC Scan	+ 0 -	6.3	0.1
Study: J Infect. 2000 Jan;40(1):31-41. PMID: 10762109

Good Negative Likelihood Ratio
Finding	Result	+LR	-LR
[ + ] Transvaginal US	+ 0 -	1.7	0.3
NOTE: very large CI for specificity (5-100%)! Study: J Infect. 2000 Jan;40(1):31-41. PMID: 10762109
[ + ] Elevated ESR	+ 0 -	1.6	0.4
Study: J Infect. 2000 Jan;40(1):31-41. PMID: 10762109

Good Positive Likelihood Ratio
Finding	Result	+LR	-LR
[ + ] Purulent endocervical secretion	+ 0 -	3.3	0.8
in 61 women with non-specific lower abdominal pain. Study: Infect Dis Obstet Gynecol. 2002;10(4):171-80; PMID: 12648310
[ + ] Rebound	+ 0 -	2.5	0.8
in 61 women with non-specific lower abdominal pain. Study: Infect Dis Obstet Gynecol. 2002;10(4):171-80; PMID: 12648310

Poorly Diagnostic Findings
Finding	Result	+LR	-LR
[ + ] Proctitis Symptoms	+ 0 -	1.3	1
Study: Sex Transm Infect. 2003 Dec;79(6):491-4. PMID: 14663128
[ + ] Emesis	+ 0 -	1.2	1
Study: Sex Transm Infect. 2003 Dec;79(6):491-4. PMID: 14663128
[ + ] Vaginal Bleeding	+ 0 -	1.1	1
Study: Sex Transm Infect. 2003 Dec;79(6):491-4. PMID: 14663128
[ + ] Vaginal discharge	+ 0 -	1.5	0.8
in 61 women with non-specific lower abdominal pain. Another meta-analysis gave 74%/24%. Study: Infect Dis Obstet Gynecol. 2002;10(4):171-80; PMID: 12648310 Sex Transm Infect. 2003 Dec;79(6):491-4. PMID: 14663128
[ + ] Adnexal Mass	+ 0 -	1.7	0.7
palpable Study: Sex Transm Infect. 2003 Dec;79(6):491-4. PMID: 14663128
[ + ] hearing loss	+ 0 -	1.3	0.8
Study: Sex Transm Infect. 2003 Dec;79(6):491-4. PMID: 14663128
[ + ] Menstrual Irregularity	+ 0 -	1	1
Study: Sex Transm Infect. 2003 Dec;79(6):491-4. PMID: 14663128
[ + ] Cervical motion tenderness	+ 0 -	1.1	0.9
in 61 women with non-specific lower abdominal pain Study: Infect Dis Obstet Gynecol. 2002;10(4):171-80; PMID: 12648310
[ + ] Leukocytosis	+ 0 -	0.8	1.3
Study: J Infect. 2000 Jan;40(1):31-41. PMID: 10762109
[ + ] Adnexal tenderness	+ 0 -	1	1.2
in 61 women with non-specific lower abdominal pain Study: Infect Dis Obstet Gynecol. 2002;10(4):171-80; PMID: 12648310
[ + ] Abdominal US		Sensitivity = 78%
Study: J Infect. 2000 Jan;40(1):31-41. PMID: 10762109