Table 2 Diagnostic and performance measures of the speculum examination in the three patient groups.
| SYM (n = 12 073) | CON (n = 1676) | ASYM (n = 2169) | |
|---|---|---|---|
| Speculum examination, relevant lesion, % (n) | 11.8 (1425) | 4.6 (77) | 3.9 (85) |
| Syphilis | 5.9 (713) | 1.7 (29) | 0.6 (14) |
| Herpes | 4.2 (513) | 0.6 (11) | 1.7 (37) |
| Referral | 1.6 (199) | 2.2 (37) | 1.6 (34) |
| Performance* | |||
| Sensitivity (%, 95% CI) | 10.8 (9.6 to 12.1) | 30.2 (25.2 to 35.5) | 2.2 (0.8 to 4.7) |
| Specificity (%, 95% CI) | 95.3 (94.9 to 95.7) | 75 (72.6 to 77.3) | 99.3 (98.8 to 99.6) |
| PPV (95% CI) | 40 (36.3 to 43.8) | 22.5 (18.6 to 26.7) | 30 (11.9 to 54.3) |
| NPV (95% CI) | 78.7 (77.9 to 79.5) | 81.7 (79.4 to 83.8) | 87.6 (86.2 to 89) |
| LR+ (95% CI) | 2.3 (2 to 2.7) | 1.21 (1 to 1.5) | 3 (1.16 to 7.71) |
| LR– (95% CI) | 0.9 (0.9 to 1) | 0.9 (0.9 to 1) | 1 (0.9 to 1) |
| Bimanual examination, any sign, % (n) | 8 (966) | 2.2 (34) | 1.2 (26) |
| PID | 5.4 (657) | 0.6 (10) | 0.3 (7) |
| Referral | 1.1 (129) | 0.2 (4) | 0.3 (6) |
ASYM, asymptomatic patients not known to be contacts of partners with a sexually transmitted infection (STI) presenting to clinic for a check‐up; CON, asymptomatic patients who are known contacts of partners with an STI; LR−, negative likelihood ratio; LR+, positive likelihood ratio; NPV, negative predictive value; PID, pelvic inflammatory disease; PPV, positive predictive value; SYM, symptomatic group.
*Likelihood that a cervicovaginal lesion found on speculum examination would lead to a clinical diagnosis of herpes or syphilis, or a referral for further clinical evaluation.