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Deriving a clinical prediction rule to target sexual healthcare to women attending British General Practices
journal contribution
posted on 2023-06-09, 13:13 authored by N L Edelman, Jackie Cassell, C H Mercer, Stephen BremnerStephen Bremner, Chris JonesChris Jones, A Gersten, Richard De VisserRichard De VisserSome 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, bingedrinking 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
History
Publication status
- Published
File Version
- Accepted version
Journal
Preventive MedicineISSN
0091-7435Publisher
ElsevierExternal DOI
Volume
112Page range
185-192Department affiliated with
- Primary Care and Public Health Publications
Full text available
- Yes
Peer reviewed?
- Yes
Legacy Posted Date
2018-05-14First Open Access (FOA) Date
2018-05-14First Compliant Deposit (FCD) Date
2018-05-14Usage metrics
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