Edelman, NL;
Cassell, JA;
Mercer, CH;
Bremner, SA;
Jones, CI;
Gersten, A;
deVisser, RO;
(2018)
Deriving a clinical prediction rule to target sexual healthcare to women attending British General Practices.
Preventive Medicine
, 112
pp. 185-192.
10.1016/j.ypmed.2018.04.030.
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Abstract
Some women attending General Practices (GPs) are at higher risk of unintended pregnancy (RUIP) and sexually transmitted infections (STI) than others. A clinical prediction rule (CPR) may help target resources using psychosocial questions as an acceptable, effective means of assessment. The aim was to derive a CPR that discriminates women who would benefit from sexual health discussion and intervention. Participants were recruited to a cross-sectional survey from six GPs in a city in South-East England in 2016. On arrival, female patients aged 16–44 years were invited to complete a questionnaire that addressed psychosocial factors, and the following self-reported outcomes: 2+ sexual partners in the last year (2PP) and RUIP. For each sexual risk, psychosocial questions were retained from logistic regression modelling which best discriminated women at risk using the C-statistic. Sensitivity and specificity were established in consultation with GP staff. The final sample comprised N = 1238 women. 2PP was predicted by 11 questions including age, binge-drinking weekly, ever having a partner who insulted you often, current smoking, and not cohabiting (C-statistic = 0.83, sensitivity = 73% and specificity = 77%). RUIP was predicted by 5 questions including sexual debut <16 years, and emergency contraception use in the last 6 months (C-statistic = 0.70, sensitivity = 69% and specificity = 57%). 2PP was better discriminated than RUIP but neither to a clinically-useful degree. The finding that different psychosocial factors predicted each outcome has implications for prevention strategies. Further research should investigate causal links between psychosocial factors and sexual risk.
| Type: | Article |
|---|---|
| Title: | Deriving a clinical prediction rule to target sexual healthcare to women attending British General Practices |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.ypmed.2018.04.030 |
| Publisher version: | https://doi.org/10.1016/j.ypmed.2018.04.030 |
| Language: | English |
| Additional information: | Copyright © 2018 The Authors. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/BY-NC-ND/4.0/). |
| Keywords: | Primary care, Sexually transmitted infections, Women, Contraception, Sexual behaviour, Primary prevention, Sexual healthcare, Reproductive healthcare |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10049660 |
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