Evidence map›Paper›PMID 22767614›Full record

Trial reportBMJ (Clinical research ed.)2012

Effectiveness of yearly, register based screening for chlamydia in the Netherlands: controlled trial with randomised stepped wedge implementation.

Ingrid V F van den Broek, Jan E A M van Bergen, Elfi E H G Brouwers, Johannes S A Fennema, Hannelore M Götz, Christian J P A Hoebe, Rik H Koekenbier, Mirjam Kretzschmar, Eelco A B Over, Boris V Schmid and 6 more

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ (Clinical research ed.), 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 71 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
71citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

71 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Pooled it
  2. Recommendation on screening for chlamydia and gonorrhea in primary care for individuals not known to be at high risk.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2021
    Guideline
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  16. Estimated effect of reduced asymptomatic testing on missedThe Lancet regional health. Europe · 2025
    Article
  17. Review
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  20. Reproductive tract complication risks followingThe Lancet regional health. Europe · 2024
    Article

11 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

16 authors.

Ingrid V F van den BroekUnit of Epidemiology and Surveillance, RIVM/Centre for Infectious Disease Control Netherlands, PO Box 1, 3720 BA Bilthoven, Netherlands.
Jan E A M van Bergen
Elfi E H G Brouwers
Johannes S A Fennema
Hannelore M Götz
Christian J P A Hoebe
Rik H Koekenbier
Mirjam Kretzschmar
Eelco A B Over
Boris V Schmid
Lydia L Pars
Sander M van Ravesteijn
Marianne A B van der Sande
G Ardine de Wit
Nicola Low
Eline L M Op de Coul

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate the effectiveness of register based, yearly chlamydia screening.

designControlled trial with randomised stepped wedge implementation in three blocks.

settingThree regions of the Netherlands: Amsterdam, Rotterdam, and South Limburg.

participants317 304 women and men aged 16-29 years listed on municipal registers at start of trial.

interventionFrom March 2008 to February 2011, the Chlamydia Screening Implementation programme offered yearly chlamydia screening tests. Postal invitations asked people to use an internet site to request a kit for self collection of samples, which would then be sent to regional laboratories for testing. Treatment and partner notification were done by the general practitioner or at a sexually transmitted infection clinic.

main outcome measuresPrimary outcomes were the percentage of chlamydia tests positive (positivity), percentage of invitees returning a specimen (uptake), and estimated chlamydia prevalence. Secondary outcomes were positivity according to sex, age, region, and sociodemographic factors; adherence to screening invitations; and incidence of self reported pelvic inflammatory disease.

resultsThe participation rate was 16.1% (43 358/269 273) after the first invitation, 10.8% after the second, and 9.5% after the third, compared with 13.0% (6223/48 031) in the control block invited at the end of round two of the intervention. Chlamydia positivity in the intervention blocks at the first invitation was the same as in the control block (4.3%) and 0.2% lower at the third invitation (odds ratio 0.96 (95% confidence interval 0.83 to 1.10)). No substantial decreases in positivity were seen after three screening rounds in any region or sociodemographic group. Among the people who participated three times (2.8% of all invitees), positivity fell from 5.9% to 2.9% (odds ratio 0.49 (0.47 to 0.50)).

conclusionsThere was no statistical evidence of an impact on chlamydia positivity rates or estimated population prevalence from the Chlamydia Screening Implementation programme after three years at the participation levels obtained. The current evidence does not support a national roll out of this register based chlamydia screening programme.

trial registrationNTR 3071 (Netherlands Trial Register, www.trialregister.nl).

Indexed as

Early DiagnosisRegistriesAdolescentAdultChlamydia InfectionsChlamydia trachomatisFemaleHumansIncidenceMaleMass ScreeningNetherlandsPrevalenceSurveys and QuestionnairesTime FactorsYoung Adult

Identifiers

PMID22767614
PMCPMC3390168

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.