Chaijareenont Kantida, Sirimai Korakot, Boriboonhirunsarn Dittakarn, Kiriwat Orawan
Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
J Med Assoc Thai. 2004 Nov;87(11):1270-4.
To determine the diagnostic accuracy of Nugent's score and each Amsel's criterion in the diagnosis of bacteria vaginosis (BV), considering Amsel's criteria as the gold standard.
Cross-sectional, descriptive study (diagnostic test) Setting: Family planning clinic, Siriraj Hospital, Mahidol University.
A total of 217 women who attended the Family Planning Clinic at Siriraj Hospital between August and December 2003.
Pelvic examination was performed on each participant. Samples of vaginal discharge was tested for BV infection using both Amsel's criteria and Nugent's score. Interpretation was made blinded without knowledge of each test result. Using Amsel's criteria as a gold standard, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of Nugent's score and each of Amsel's criteria were estimated.
Considering Amsel's criteria as the gold standard, Nugent's score showed a sensitivity of 65.6% (95%CI 46.8%, 80.8%), specificity of 97.3% (95%CI 93.5%, 99.0%), positive predictive value (PPV) of 80.8% (95%CI 60.0%, 92.7%), negative predictive value (NPV) of 94.2% (95%CI 89.7%, 96.9%) and accuracy of 92.6% (95%CI 88.1%, 95.6%). Both vaginal pH and whiff test demonstrated 100% sensitivity. However, vaginal pH showed lower specificity than the whiff test (58.9% and 97.3% respectively).
Nugent's score might not be suitable to use as a screening test for diagnosis of BV due to its low sensitivity. The whiff test is the best clinical criteria of Amsel's criterion in the diagnosis of BV due to its high sensitivity and specitivity.
以阿姆斯勒标准为金标准，确定纽金特评分及各阿姆斯勒标准对细菌性阴道病（BV）的诊断准确性。
横断面描述性研究（诊断试验）
玛希隆大学诗里拉吉医院计划生育诊所
2003年8月至12月期间在诗里拉吉医院计划生育诊所就诊的217名女性。
对每位参与者进行盆腔检查。使用阿姆斯勒标准和纽金特评分对阴道分泌物样本进行BV感染检测。在不知道各项检测结果的情况下进行盲法判读。以阿姆斯勒标准为金标准，估算纽金特评分及各阿姆斯勒标准的敏感性、特异性、阳性预测值、阴性预测值和准确性。
以阿姆斯勒标准为金标准时，纽金特评分的敏感性为65.6%（95%可信区间46.8%，80.8%），特异性为97.3%（95%可信区间93.5%，99.0%），阳性预测值（PPV）为80.8%（95%可信区间60.0%，92.7%），阴性预测值（NPV）为94.2%（95%可信区间89.7%，96.9%），准确性为92.6%（95%可信区间88.1%，95.6%）。阴道pH值和胺试验的敏感性均为100%。然而，阴道pH值的特异性低于胺试验（分别为58.9%和97.3%）。
由于纽金特评分敏感性较低，可能不适用于BV诊断的筛查试验。胺试验因其高敏感性和特异性，是阿姆斯勒标准中诊断BV的最佳临床标准。
