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Anthony L. Komaroff, MD; Theodore M. Pass, PhD; Jack D. McCue, MD; Alan B. Cohen, MS; T. Michael Hendricks, MS; Gerald Friedland, MD

Arch Intern Med. 1978;138(7):1069-1073.

Abstract
Detailed history, physical examination, laboratory and follow-up data were obtained from 821 women coming to a primary care clinic over a two-year period with the symptoms of urinary tract (UTI) or vaginal infection. Using all available information, each patient retrospectively was given one of several mutually exclusive diagnoses. Vaginitis without UTI was diagnosed in 70% of patients, UTI without vaginitis in 12%, UTI and vaginitis in 2%. The conditional probability of the several possible diagnoses was calculated, given various combinations of clinical data; a diagnosis of vaginitis was twice as likely as a diagnosis of UTI in a patient with dysuria. On the basis of these calculations we identified efficient clinical strategies for when to perform a pelvic examination, a urinalysis, and a urine culture, and when to diagnose UTI presumptively on the basis of urinalysis.

(Arch Intern Med 138:1069-1073, 1978)

Author Affiliations
From the Ambulatory Care Project, Thorndike Laboratory, Department of Medicine, Division of Infectious Diseases, Harvard Medical School and Beth Israel Hospital, Boston.

Footnotes
Accepted for publication Aug 8, 1977.

Read in part before the American Federation for Clinical Research annual meeting, Washington, DC, May 2, 1977.

Reprint requests to Ambulatory Care Project, Department of Medicine, Beth Israel Hospital, 330 Brookline Ave, Boston, MA 02115 (Dr Komaroff).

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