Frisse, Ann C.Marrazzo, Jeanne M.Tutlam, Nhial T.Schreiber, Courtney A.Teal, Stephanie B.Turok, David K.Peipert, Jeffrey F.2019-06-102019-06-102017-04Frisse, A. C., Marrazzo, J. M., Tutlam, N. T., Schreiber, C. A., Teal, S. B., Turok, D. K., & Peipert, J. F. (2017). Validity of self-reported history of Chlamydia trachomatis infection. American journal of obstetrics and gynecology, 216(4), 393.e1–393.e7. doi:10.1016/j.ajog.2016.12.005https://hdl.handle.net/1805/19577BACKGROUND: Chlamydia trachomatis infection is common and largely asymptomatic in women. If untreated, it can lead to sequelae such as pelvic inflammatory disease and infertility. It is unknown whether a patient's self-reported history of Chlamydia trachomatis infection is a valid marker of past infection. OBJECTIVE: Our objective was to evaluate the validity of women's self-reported history of Chlamydia trachomatis infection compared with Chlamydia trachomatis serology, a marker for previous infection. STUDY DESIGN: We analyzed data from the Fertility After Contraception Termination study. We compared participants' survey responses with the question, "Have you ever been told by a health care provider that you had Chlamydia?" to serological test results indicating the presence or absence of antibodies to Chlamydia trachomatis as assessed by a microimmunofluorescence assay. Prevalence of past infection, sensitivity, specificity, predictive values, and likelihood ratios were calculated. The Cohen's kappa statistic was computed to assess agreement between self-report and serology. RESULTS: Among 409 participants, 108 (26%) reported having a history of Chlamydia trachomatis infection, whereas 146 (36%) had positive serological test results. Relative to positive microimmunofluorescence assay, the sensitivity and specificity of self-reported history of Chlamydia trachomatis infection were 52.1% (95% confidence interval, 43.6-60.4%) and 87.8% (95% confidence interval, 83.3-91.5%), respectively. The positive predictive value of the self-report was 70.4% (95% confidence interval, 60.8-78.8%), and the negative predictive value was 76.7% (95% confidence interval, 71.6-81.4%). The likelihood ratio was found to be 4.28. Agreement between self-report and serology was found to be moderate (kappa = 0.42, P < .001). CONCLUSION: Self-reported history of Chlamydia trachomatis infection commonly yields false-negative and false-positive results. When definitive status of past Chlamydia trachomatis infection is needed, serology should be obtained.en-USPublisher PolicyChlamydia trachomatisMicroimmunofluorescence assaySelf-reportSerologySexually transmitted infectionValidityArticle