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December 23, 1988

The Predictive Power and Cost of Screening for Chlamydia

JAMA. 1988;260(24):3590. doi:10.1001/jama.1988.03410240048022

To the Editor.—  In a recent article entitled "Cost-effectiveness of Screening Women at Moderate Risk for Genital Infections Caused by Chlamydia trachomatis,"1 there appear to be two contradictory statements that are crucial to the conclusions made by the authors.At one point, the statement is made that "the absolute sensitivity of a single endocervical direct antigen test was assumed to be 53% (ie, a direct antigen test would detect a true infection 53% of the time), and the specificity, 96%."Later in the article, while discussing the strategy of performing this test on all patients and treating those with positive results, the authors state that, "if this strategy were implemented, only 53% of treated patients would actually be infected." And later in the same paragraph comes another confusing statement that is more in agreement with their first statement regarding the test's sensitivity: "only half of infected patients would be