Despite government efforts to expand diagnostic criteria for pelvic inflammatory disease, emergency department doctors are not identifying the condition any more often in adolescent girls, finds a new study in Journal of Adolescent Health.
Pelvic inflammatory disease, or PID, is a complication of sexually transmitted infections, such as chlamydia or gonorrhea. PID disproportionately affects teen girls and young women. Unfortunately, doctors often miss the diagnosis. Early diagnosis is important, since if left untreated, PID can result in infertility, chronic pelvic pain, pelvic abscesses, and other serious conditions. To help doctors identify PID earlier, the Centers for Disease Control and Prevention (CDC) broadened the diagnostic criteria for the condition in 2002.
Monika Goyal, M.D. and colleagues looked at data from the 2000-2009 National Hospital Ambulatory Medical Care Survey. Of an estimated 77 million emergency department visits by 14- to 21-year-old adolescents, there were approximately 705,000 diagnosed cases of PID. "We found there was a slight but not significant decrease in the diagnosis rate after the revised CDC criteria were published," said Goyal, a pediatrician at the Children's National Medical Center in Washington, DC.
"Based on these findings, it's hard to know what exactly is going on," Goyal said. "We don't know if it's because PID has definitely declined or because we're just not thinking about it as much as we should. One of our concerns is we are still missing girls that have PID."
"It's hard to tell exactly why there was no significant change. I think it's a combination of things. When the CDC broadened the criteria in 2002, it was because doctors were missing 15 percent of PID cases. So there is probably still some of that going on," commented Angela Diaz, M.D., program and research director of Mount Sinai's Adolescent Health Center in New York City.