{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T11:29:56Z","timestamp":1761391796250,"version":"build-2065373602"},"reference-count":35,"publisher":"CSIRO Publishing","issue":"3","license":[{"start":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T00:00:00Z","timestamp":1746403200000},"content-version":"vor","delay-in-days":2224,"URL":"https:\/\/doi.org\/10.1071\/journalslicense"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,6,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>A 2006 Australian sexual health clinic audit of pelvic inflammatory disease (PID) diagnosis rates found variability between doctors. Doctors were given audit feedback towards increasing diagnosis and reducing variability. The clinic implemented other improvements to increase capacity. This study investigated PID diagnosis time trends before and after feedback. Methods: Yearly PID diagnosis rates for women aged 16\u201349 years attending the clinic (2002\u201316) were calculated. Using multivariable generalised linear mixed models, adjusted for patient risk and lower genital infection (any of chlamydia, gonorrhoea, Mycoplasma genitalium, bacterial vaginosis) and stratified by before (2002\u2013June 2007) and after (July 2007\u20132016) feedback, we assessed if PID rates changed over time, accounting for between-doctor variability. Results: During 2002-16, 144 doctors undertook 84 476 female consultations and diagnosed 1755 (2.1%, 95% confidence interval (CI) 2.0\u20132.2) with PID. Comparing 2002\u201303 to 2015\u201316, the yearly PID rate increased; 0.8% (37\/4836) to 2.9% (209\/7088). Comparing before and after feedback more women reported any symptoms at triage (35.1%\u201347.2%) or had a lower genital infection diagnosed (10.1%\u201314.9%). After feedback, PID rates increased by 8% yearly (incidence rate ratio (IRR) 1.08, 95% CI 1.06\u20131.11), but were unchanged (adjusted IRR (aIRR) 1.01, 95% CI 0.98\u20131.03) after adjustment for patient characteristics. Factors associated with PID were self-reported symptoms, younger age and a lower genital infection. Lower variability in doctor-specific rates was observed after feedback. Conclusions: Increasing PID diagnosis rates appeared to be driven by a greater female patient risk profile, influenced by increased capacity following service improvements.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1071\/sh18119","type":"journal-article","created":{"date-parts":[[2019,4,2]],"date-time":"2019-04-02T22:11:47Z","timestamp":1554243107000},"page":"247-253","source":"Crossref","is-referenced-by-count":2,"title":["Trends in diagnosis of pelvic inflammatory disease in an Australian sexual health clinic, 2002\u201316: before and after clinical audit feedback"],"prefix":"10.1071","volume":"16","author":[{"given":"Jane L.","family":"Goller","sequence":"first","affiliation":[{"name":"AMelbourne School of Population & Global Health, University of Melbourne, 207 Bouverie Street, Parkville, Vic. 3010, Australia."},{"name":"DCorresponding author. Email: jane.goller@unimelb.edu.au"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher K.","family":"Fairley","sequence":"additional","affiliation":[{"name":"BCentral Clinical School, Monash University and Melbourne Sexual Health Centre, 580 Swanston Street, Carlton, Vic. 3053, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alysha M.","family":"De Livera","sequence":"additional","affiliation":[{"name":"AMelbourne School of Population & Global Health, University of Melbourne, 207 Bouverie Street, Parkville, Vic. 3010, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcus Y.","family":"Chen","sequence":"additional","affiliation":[{"name":"BCentral Clinical School, Monash University and Melbourne Sexual Health Centre, 580 Swanston Street, Carlton, Vic. 3053, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catriona S.","family":"Bradshaw","sequence":"additional","affiliation":[{"name":"BCentral Clinical School, Monash University and Melbourne Sexual Health Centre, 580 Swanston Street, Carlton, Vic. 3053, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1766-0657","authenticated-orcid":true,"given":"Eric P. F.","family":"Chow","sequence":"additional","affiliation":[{"name":"BCentral Clinical School, Monash University and Melbourne Sexual Health Centre, 580 Swanston Street, Carlton, Vic. 3053, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Guy","sequence":"additional","affiliation":[{"name":"CThe Kirby Institute, UNSW Sydney, Wallace Wurth Building, High Street, Kensington, NSW 2052, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane S.","family":"Hocking","sequence":"additional","affiliation":[{"name":"AMelbourne School of Population & Global Health, University of Melbourne, 207 Bouverie Street, Parkville, Vic. 3010, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"67","published-online":{"date-parts":[[2019,4,3]]},"reference":[{"issue":"21","key":"2025102419085577900_R1","doi-asserted-by":"publisher","first-page":"2039","DOI":"10.1056\/NEJMra1411426","article-title":"Pelvic inflammatory disease.","volume":"372","author":"Brunham","year":"2015","journal-title":"N Engl J Med"},{"key":"2025102419085577900_R2","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1258\/ijsa.2011.011362","article-title":"Pelvic inflammatory disease in adolescents between the time of testing and treatment and after treatment for gonorrhoeal and chlamydial infection.","volume":"23","author":"Risser","year":"2012","journal-title":"Int J STD AIDS"},{"issue":"4","key":"2025102419085577900_R3","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0094361","article-title":"Hospitalisations for pelvic inflammatory disease temporally related to a diagnosis of Chlamydia or gonorrhoea: a retrospective cohort study.","volume":"9","author":"Reekie","year":"2014","journal-title":"PLoS One"},{"issue":"6","key":"2025102419085577900_R4","doi-asserted-by":"publisher","first-page":"989","DOI":"10.1097\/00006250-199406000-00019","article-title":"Risk factors associated with pelvic inflammatory disease of differing microbial etiologies.","volume":"83","author":"Jossens","year":"1994","journal-title":"Obstet Gynecol"},{"issue":"3","key":"2025102419085577900_R5","doi-asserted-by":"publisher","first-page":"418","DOI":"10.1093\/cid\/civ312","article-title":"Mycoplasma genitalium infection and female reproductive tract disease: a meta-analysis.","volume":"61","author":"Lis","year":"2015","journal-title":"Clin Infect Dis"},{"issue":"2","key":"2025102419085577900_R6","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1097\/OLQ.0b013e31827c5a5b","article-title":"Does bacterial vaginosis cause pelvic inflammatory disease?","volume":"40","author":"Taylor","year":"2013","journal-title":"Sex Transm Dis"},{"issue":"6","key":"2025102419085577900_R7","doi-asserted-by":"publisher","first-page":"558","DOI":"10.1111\/j.1471-0528.1993.tb15308.x","article-title":"Morbidity following pelvic inflammatory disease.","volume":"100","author":"Buchan","year":"1993","journal-title":"Br J Obstet Gynaecol"},{"issue":"9","key":"2025102419085577900_R8","doi-asserted-by":"publisher","first-page":"879","DOI":"10.1097\/OLQ.0b013e31821f918c","article-title":"Recurrent PID, subsequent STI, and reproductive health outcomes: findings from the PID Evaluation and Clinical Health (PEACH) Study.","volume":"38","author":"Trent","year":"2011","journal-title":"Sex Transm Dis"},{"issue":"5","key":"2025102419085577900_R9","doi-asserted-by":"publisher","first-page":"1503","DOI":"10.1016\/S0002-9378(11)90790-X","article-title":"Delayed care of pelvic inflammatory disease as a risk factor for impaired fertility.","volume":"168","author":"Hillis","year":"1993","journal-title":"Am J Obstet Gynecol"},{"key":"2025102419085577900_R10","first-page":"76","article-title":"Sexually transmitted diseases treatment guidelines, 2015.","volume":"64","author":"Centres for Disease Control and Prevention.","year":"2015","journal-title":"MMWR Recomm Rep"},{"key":"2025102419085577900_R11","unstructured":"Australasian Sexual Health Alliance. 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