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Study suggests federal guidelines for treating teen PID need clarification
Date:4/9/2013

ual partners.

Trent says the study revealed a gender and parental bias in decision-making. Male clinicians and non-parent clinicians were more likely than their female and parent colleagues to hospitalize patients, the study found.

"We found that some clinicians are simply uncomfortable sending a teen home and asking her to follow a complicated PID treatment regimen and return for follow-up visits, despite existing guidelines stating they should do just that," Trent says.

Designed properly, Trent adds, clinical guidelines should offer clear decision-making algorithms while giving physicians autonomy and flexibility. Lack of clarity, however, can force clinicians to make decisions predicated on personal bias rather than on evidence stemming from best practices, the investigators say.

In the study, the clinicians were presented with 17 clinical vignettes involving a hypothetical 15-year-old with PID, then asked to choose between hospital and outpatient treatment for each scenario. The clinicians had to weigh various factors, such as the patient's severity of illness and age, whether the patient was pregnant, whether the patient has had recent surgical procedures, whether the patient was afraid of sharing her diagnosis with a partner and whether the patient appeared able and willing to follow outpatient treatment regimen.

Each year, 800,000 girls and women in the United States develop PID, according to the CDC, and 10 percent of them develop infertility as a result. PID can lead to an array of other long-term problems including ectopic pregnancy and chronic pelvic pain, the researchers say.


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Contact: Ekaterina Pesheva
peshev1@jhmi.edu
410-502-9433
Johns Hopkins Medicine
Source:Eurekalert

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