Accuracy of self-screening for contraindications to combined oral contraceptive use
Accuracy of self-screening for contraindications to combined oral contraceptive use
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DOI：
10.1097/aog.0b013e31818345f0
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发表时间：
2008-09-01
影响因子：
7.2
通讯作者：
Potter, Joseph E.
中科院分区：
文献类型：
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作者：
Grossman, Daniel;Fernandez, Leticia;Potter, Joseph E.
目的：为了估计如何方便样本的妇女从一般人群中可以自我筛选禁忌症结合口服避孕药使用medical checklist.METHODS：妇女18-49岁（N=1,271）被招募在两个购物中心和跳蚤市场在埃尔帕索，得克萨斯州，并首先询问他们是否认为避孕药是医学上安全的。然后，他们根据世界卫生组织的医疗资格标准，使用一份清单来确定复方口服避孕药的3级或4级禁忌症。然后，妇女进行了采访，由一个盲护士执业，谁也measured blood pressure.RESULTS：检测真正的禁忌症的灵敏度为56.2%（95%置信区间[CI] 51.7-60.6%），特异性为57.6%（95%CI 54.0-61.1%）。检查表检测真正禁忌症的敏感性为83.2%（95% CI 79.5-86.3%），特异性为88.8%（95% CI 86.3-90.9%）。使用检查表，6.6%（95% CI 5.2-8.0%）的女性错误地认为她们有资格使用，而事实上，她们是禁忌的，主要是因为未被认识到的高血压。7%（95%CI 5.4-8.2%）的女性错误地认为自己是禁忌症，而实际上并非如此，主要是因为偏头痛的错误分类。在回归分析中，年轻女性、受教育程度较高的女性和讲西班牙语的女性更有可能正确地进行自我筛查（P
OBJECTIVE: To estimate how well a convenience sample of women from the general population could self-screen for contraindications to combined oral contraceptives using a medical checklist.METHODS: Women 18-49 years old (N=1,271) were recruited at two shopping malls and a flea market in El Paso, Texas, and asked first whether they thought birth control pills were medically safe for them. They then used a checklist to determine the presence of level 3 or 4 contraindications to combined oral contraceptives according to the World Health Organization Medical Eligibility Criteria. The women then were interviewed by a blinded nurse practitioner, who also measured blood pressure.RESULTS: The sensitivity of the unaided self-screen to detect true contraindications was 56.2% (95% confidence interval [CI] 51.7-60.6%), and specificity was 57.6% (95% CI 54.0-61.1%). The sensitivity of the checklist to detect true contraindications was 83.2% (95% CI 79.5-86.3%), and specificity was 88.8% (95% CI 86.3-90.9%). Using the checklist, 6.6% (95% CI 5.2-8.0%) of women incorrectly thought they were eligible for use when, in fact, they were contraindicated, largely because of unrecognized hypertension. Seven percent (95% CI 5.4-8.2%) of women incorrectly thought they were contraindicated when they truly were not, primarily because of misclassification of migraine headaches. in regression analysis, younger women, more educated women, and Spanish speakers were significantly more likely to correctly self-screen (P