Evidence map›Paper›PMID 25504295›Full record

ArticleSexually transmitted diseases2015

Could home sexually transmitted infection specimen collection with e-prescription be a cost-effective strategy for clinical trials and clinical care?

Diane R Blake, Freya Spielberg, Vivian Levy, Shelly Lensing, Peter A Wolff, Lalitha Venkatasubramanian, Nincoshka Acevedo, Nancy Padian, Ishita Chattopadhyay, Charlotte A Gaydos

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Sexually transmitted diseases, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 1 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

16 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Diane R BlakeFrom the *Department of Pediatrics, University of Massachusetts Medical School, Worcester, MA; †Department of Prevention and Community Health, George Washington University School of Public Health, Washington, DC; ‡San Mateo County Health System, San Mateo, CA; §Division of Infectious Diseases, Stanford University, Stanford, CA; ¶Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, AR; ∥National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD; **FHI360, Durham, NC; ††Division of Epidemiology, University of California, Berkeley, CA; and ‡‡Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, Baltimore, MD.
Freya Spielberg
Vivian Levy
Shelly Lensing
Peter A Wolff
Lalitha Venkatasubramanian
Nincoshka Acevedo
Nancy Padian
Ishita Chattopadhyay
Charlotte A Gaydos

Funding

TrainingU54EB007958 · NIBIB · JOHNS HOPKINS UNIVERSITY · PI Yukari C Manabe · 2007 to 2026
$34.6M
HIV Prevention Trials Network: Network LaboratoryU01AI068613 · NIAID · JOHNS HOPKINS UNIVERSITY · PI ESHLEMAN, SUSAN H · 2006 to 2010
$16.5M
NIAID NIH HHS HHSN266200400074CNIAID NIH HHS U01 AI068613NIBIB NIH HHS U54 EB007958PHS HHS HHSN266200400074C
6 · The paper itself

Abstract

backgroundResults of a recent demonstration project evaluating feasibility, acceptability, and cost of a Web-based sexually transmitted infection (STI) testing and e-prescription treatment program (eSTI) suggest that this approach could be a feasible alternative to clinic-based testing and treatment, but the results need to be confirmed by a randomized comparative effectiveness trial.

methodsWe modeled a decision tree comparing (1) cost of eSTI screening using a home collection kit and an e-prescription for uncomplicated treatment versus (2) hypothetical costs derived from the literature for referral to standard clinic-based STI screening and treatment. Primary outcome was number of STIs detected. Analyses were conducted from the clinical trial perspective and the health care system perspective.

resultsThe eSTI strategy detected 75 infections, and the clinic referral strategy detected 45 infections. Total cost of eSTI was $94,938 ($1266/STI detected) from the clinical trial perspective and $96,088 ($1281/STI detected) from the health care system perspective. Total cost of clinic referral was $87,367 ($1941/STI detected) from the clinical trial perspective and $71,668 ($1593/STI detected) from the health care system perspective.

conclusionsResults indicate that eSTI will likely be more cost-effective (lower cost/STI detected) than clinic-based STI screening, both in the context of clinical trials and in routine clinical care. Although our results are promising, they are based on a demonstration project and estimates from other small studies. A comparative effectiveness research trial is needed to determine actual cost and impact of the eSTI system on identification and treatment of new infections and prevention of their sequelae.

Indexed as

Decision TreesAmbulatory Care FacilitiesClinical Trials as TopicCost-Benefit AnalysisElectronic PrescribingHumansReagent Kits, DiagnosticReferral and ConsultationSexually Transmitted DiseasesSpecimen HandlingReagent Kits, Diagnostic

Identifiers

PMID25504295
PMCPMC4276035

What OpenQuestion holds

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LicenceTDM
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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.