Predictive value of reportable medical events for Neisseria gonorrhoeae and Chlamydia trachomatis.

Neisseria gonorrhoeae (gonorrhea) and Chlamydia trachomatis (chlamydia) are notifiable diseases reported under the guidelines of the Armed Forces Reportable Medical Event Guidelines and Case Definitions. Records of clinical laboratory tests (Health Level 7) were used to calculate the sensitivity, specificity, and positive predictive value (PPV) of confirmed reportable medical events (RMEs) for gonorrhea and chlamydia. The sensitivity--which reflects the proportion of "true cases" identified by an RME--was 65 percent and 62 percent for gonorrhea and chlamydia, respectively. The specificity--the percentage of individuals with negative lab tests who did not have RMEs--was high (>98%) for both infections. The PPV--the percentage of people with an RME who have a positive test--was also relatively high (>80%) for both infections. Using confirmed RMEs alone to estimate incident cases of gonorrhea and chlamydia may underestimate the true disease burden.