Potential for bias in studies of the influence of human immunodeficiency virus infection on the recognition, incidence, clinical course, and microbiology of pelvic inflammatory disease

Kathleen L. Irwin, Roselyn J. Rice, Rhoda S. Sperling, Mary Jo O’Sullivan, Michael Brodman

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

As the human immunodeficiency virus (HIV) epidemic affects more Woman immunodeficiency, clinicians are increasingly observing pelvic inflammatory disease (PID) in HIV-infected Women. The extent to which PID is a factor in the recognition women The extent to which PID is a factor in the recognition of PID is unknown. Even less is known about how HIV infection influences the development, clinical course, and microbiology of PID. The paucity of existing data largely results from difficulties in designing studies that are free of bias. Several biases may distort studies of the effect of HIV on the recognition, incidence, clinical presentation and course, and microbioogy of PID. Selection bias, diagnostic bias, and confounding bias are the most likely causes of invalid conclusions in studies of the influence of HIV infection on these aspects of PID, for three major reasons: Factors that determine patients' health care seeking behavior may be related to HIV status; the diagnosis of PID tends to be imprecise; and extraneous factors that cause or prevent PID may be distributed differently in HIV-infected and HIV-uninfected women. Appropriate study design and analytic techniques can eliminate, reduce, or estimate the magnitude and direction of these biases, thereby yielding more valid conclusions. To interpret properly existing and future studies of the influence of HIV infection on PID, clinicians must consider several biases that may distort results.

Original languageEnglish
Pages (from-to)463-469
Number of pages7
JournalObstetrics and Gynecology
Volume84
Issue number3
StatePublished - Sep 1994

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