Document 0372
 DOCN  M9490372
 TI    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.
 DT    9411
 AU    Irwin KL; Rice RJ; Sperling RS; O'Sullivan MJ; Brodman M; National
       Center for Infectious Diseases, Centers for Disease; Control and
       Prevention, Atlanta, Georgia.
 SO    Obstet Gynecol. 1994 Sep;84(3):463-9. Unique Identifier : AIDSLINE
       MED/94336136
 AB    As the human immunodeficiency virus (HIV) epidemic affects more women,
       clinicians are increasingly observing pelvic inflammatory disease (PID)
       in HIV-infected women. The extent to which PID is a factor in the
       recognition of HIV or HIV 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 microbiology 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.
 DE    Acquired Immunodeficiency Syndrome/*EPIDEMIOLOGY
       Adnexitis/*EPIDEMIOLOGY/MICROBIOLOGY  Bias (Epidemiology)  Confounding
       Factors (Epidemiology)  Female  Human  HIV Infections/*EPIDEMIOLOGY  HIV
       Seronegativity  HIV Seropositivity/EPIDEMIOLOGY  Incidence  Prevalence
       Selection Bias  Support, U.S. Gov't, P.H.S.  United States/EPIDEMIOLOGY
       JOURNAL ARTICLE

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