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Diagnostic Tests for Sexually Transmitted Disease

Peter E. Dans, MD
JAMA. 1976;235(24):2583. doi:10.1001/jama.1976.03260500011003.
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To the Editor.—  Sensitivity has been defined as "the percent of positive results in patients with the disease" and specificity as "the percent of negative results among people who do not have the disease."1 In the article "Efficacy of Selected Diagnostic Tests for Sexually Transmitted Diseases" (235:49, 1976), the authors equated positive cultures and patients with disease. If we assume that "patients with disease" refers to those in whom therapeutic intervention is indicated, isolation of the gonococcus can be considered to be an indicator of "disease" whether or not the patient has signs or symptoms. However, the isolation of Candida may merely represent colonization and may neither imply its etiology in any vaginitis nor require therapy.Furthermore, even for gonorrhea, the sensitivity of the culture techniques, even in the best of circumstances, is not 100%. This is especially true for anal canal and endocervical specimens. Repetitive testing with multiple

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