Nurse-Practitioner Clinical Diagnosis of Vaginal Infections Compared to DNA Probe Analysis

2.50
Hdl Handle:
http://hdl.handle.net/10755/151304
Type:
Presentation
Title:
Nurse-Practitioner Clinical Diagnosis of Vaginal Infections Compared to DNA Probe Analysis
Abstract:
Nurse-Practitioner Clinical Diagnosis of Vaginal Infections Compared to DNA Probe Analysis
Conference Sponsor:Sigma Theta Tau International
Conference Year:2007
Author:Lowe, Nancy K., RN, CNM, PhD
P.I. Institution Name:Oregon Health & Science University
Title:professor
Co-Authors:Nancy A. Ryan-Wenger, RN, PhD, CPNP
[Research Presentation] It is rarely demonstrated empirically that clinician diagnoses are not always accurate even when standard diagnostic protocols are followed. This report focuses on the extent of agreement between clinical diagnoses by advanced practice nurse practitioners (NP) and DNA Probe diagnosis of clinically significant vaginal infection. áEven when protocols are closely followed, diagnoses are not always clear. The APNs in this study were women's health NP research staff for a project testing the accuracy of women's self-diagnosis of vaginal symptoms compared to a DNA Probe analysis of vaginal secretions for bacterial vaginosis (BV), trichomoniasis vaginalis (TV), or candida vaginalis (CV). One component of the research protocol was a clinical diagnosis and treatment plan by the research NPs.áThe sample was 715 active duty U.S. military women (44% Army, 52.7% Navy, and 3.5% Other Branches), 546 of whom presented for healthcare with vaginal symptoms.á Participants were 38.5% Black, 33.8% White, 18.2% Hispanic or Latino; 41.6% married/cohabiting and 38.1% single; 18 to 54 years (X = 26). The majority was senior (66.4%) or young (25.7%) enlisted personnel. The Clinical Diagnoses (CD) by the NPs included 114 CV (21%), 264 BV/TV (48.6%), 72 mixed BV/CV (13.3%), 48 other (8.8%) and 45 normal (8.3%). The CD had a positive predictive value (PPV) of 80.7% and negative predictive value (NPV) of 74% for BV/TV; a PPV of 67.8% and NPV of 93.2% for CV; a PPV of 53.5% and NPV of 92.7% for Mixed BV/TV/CV infections compared to the DNA standard. Overall, the NPs correctly diagnosed 83.4% of 320 BV/TV cases, 83.8% of 148 CV cases, and 52.8% of 72 mixed infections.áFurther analysis provides insight into the components of the clinical examination related to diagnostic errors. These findings add significant new information to the literature about clinical decision-making in women's healthcare.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleNurse-Practitioner Clinical Diagnosis of Vaginal Infections Compared to DNA Probe Analysisen_GB
dc.identifier.urihttp://hdl.handle.net/10755/151304-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Nurse-Practitioner Clinical Diagnosis of Vaginal Infections Compared to DNA Probe Analysis</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2007</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Lowe, Nancy K., RN, CNM, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Oregon Health &amp; Science University</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">professor</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">lowen@ohsu.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Nancy A. Ryan-Wenger, RN, PhD, CPNP</td></tr><tr><td colspan="2" class="item-abstract">[Research Presentation] It is rarely demonstrated empirically that clinician diagnoses are not always accurate even when standard diagnostic protocols are followed. This report focuses on the extent of agreement between clinical diagnoses by advanced practice nurse practitioners (NP) and DNA Probe diagnosis of clinically significant vaginal infection. &aacute;Even when protocols are closely followed, diagnoses are not always clear. The APNs in this study were women's health NP research staff for a project testing the accuracy of women's self-diagnosis of vaginal symptoms compared to a DNA Probe analysis of vaginal secretions for bacterial vaginosis (BV), trichomoniasis vaginalis (TV), or candida vaginalis (CV). One component of the research protocol was a clinical diagnosis and treatment plan by the research NPs.&aacute;The sample was 715 active duty U.S. military women (44% Army, 52.7% Navy, and 3.5% Other Branches), 546 of whom presented for healthcare with vaginal symptoms.&aacute; Participants were 38.5% Black, 33.8% White, 18.2% Hispanic or Latino; 41.6% married/cohabiting and 38.1% single; 18 to 54 years (X = 26). The majority was senior (66.4%) or young (25.7%) enlisted personnel. The Clinical Diagnoses (CD) by the NPs included 114 CV (21%), 264 BV/TV (48.6%), 72 mixed BV/CV (13.3%), 48 other (8.8%) and 45 normal (8.3%). The CD had a positive predictive value (PPV) of 80.7% and negative predictive value (NPV) of 74% for BV/TV; a PPV of 67.8% and NPV of 93.2% for CV; a PPV of 53.5% and NPV of 92.7% for Mixed BV/TV/CV infections compared to the DNA standard. Overall, the NPs correctly diagnosed 83.4% of 320 BV/TV cases, 83.8% of 148 CV cases, and 52.8% of 72 mixed infections.&aacute;Further analysis provides insight into the components of the clinical examination related to diagnostic errors. These findings add significant new information to the literature about clinical decision-making in women's healthcare.</td></tr></table>en_GB
dc.date.available2011-10-26T10:58:06Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T10:58:06Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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