Evidence map›Paper›PMID 25512673›Full record

ArticleSexually transmitted infections2015

Confirmatory assays are essential when using molecular testing for Neisseria gonorrhoeae in low-prevalence settings: insights from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3).

Nigel Field, Soazig Clifton, Sarah Alexander, Catherine A Ison, Gwenda Hughes, Simon Beddows, Clare Tanton, Kate Soldan, Filomeno Coelho da Silva, Catherine H Mercer and 3 more

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Sexually transmitted infections, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
0.7field-weighted citation impact, top 29% of its field
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

9 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Maximizing theJournal of clinical microbiology · 2024
    Article
  5. Article
  6. Comparison between Abbott m2000 RealTime and Alinity m STI systems for detection of Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycoplasma genitalium.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2021
    Article
  7. Second- and third-generation commercial Neisseria gonorrhoeae screening assays and the ongoing issues of false-positive results and confirmatory testing.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2021
    Article
  8. The Laboratory Diagnosis ofPathogens (Basel, Switzerland) · 2020
    Review
  9. Article
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

13 authors at 5 institutions in 1 country.

Nigel FieldResearch Department of Infection & Population Health, University College London, Mortimer Market Centre, London, UK.
Soazig CliftonResearch Department of Infection & Population Health, University College London, Mortimer Market Centre, London, UK NatCen Social Research, London, UK.
Sarah AlexanderSexually Transmitted Bacteria Reference Unit, Public Health England, London, UK.
Catherine A IsonSexually Transmitted Bacteria Reference Unit, Public Health England, London, UK.
Gwenda HughesPublic Health England, National Centre for Infectious Disease Surveillance and Control, London, UK.
Simon BeddowsVirus Reference Department, Public Health England, London, UK.
Clare TantonResearch Department of Infection & Population Health, University College London, Mortimer Market Centre, London, UK.
Kate SoldanPublic Health England, National Centre for Infectious Disease Surveillance and Control, London, UK.
Filomeno Coelho da SilvaVirus Reference Department, Public Health England, London, UK.
Catherine H MercerResearch Department of Infection & Population Health, University College London, Mortimer Market Centre, London, UK.
Kaye WellingsDepartment of Social and Environmental Research, London School of Hygiene & Tropical Medicine, London, UK.
Anne M JohnsonResearch Department of Infection & Population Health, University College London, Mortimer Market Centre, London, UK.
Pam SonnenbergResearch Department of Infection & Population Health, University College London, Mortimer Market Centre, London, UK.
Public Health England · GBUniversity College London · GBMortimer Market Centre · GBLondon School of Hygiene & Tropical Medicine · GBNatCen Social Research · GB

Funding

Department of HealthMedical Research Council G0701757Wellcome Trust 084840
6 · The paper itself

Abstract

objectivesTo investigate the occurrence of unconfirmed positive gonorrhoea results when using molecular testing within a large population-based survey. DESIGN, SETTING AND

participantsBetween 2010 and 2012, we did a probability sample survey of 15,162 men and women aged 16-74 years in Britain. Urine from participants aged 16-44 years reporting ≥1 lifetime sexual partner was tested for Neisseria gonorrhoeae and Chlamydia trachomatis using the Aptima Combo 2 (AC2) assay, with positive or equivocal results confirmed with molecular assays using different nucleic acid targets.

resultsA total of 4550 participants aged 16-44 years had urine test results (1885 men; 2665 women). For gonorrhoea, 18 samples initially tested positive and eight were equivocal. Only five out of 26 confirmed, giving a positive predictive value (PPV) for the initial testing of 19% (95% CI 4% to 34%). Most (86% (18/21)) participants with unconfirmed positive results for gonorrhoea reported zero or one sexual partner without condoms in the past year and none had chlamydia co-infection, whereas all five with confirmed gonorrhoea reported at least two recent sexual partners without condoms, and four had chlamydia co-infection. The weighted prevalence for gonorrhoea positivity fell from 0.4% (0.3% to 0.7%) after initial screening to <0.1% (0.0% to 0.1%) after confirmatory testing. By comparison, 103 samples tested positive or equivocal for chlamydia and 98 were confirmed (PPV=95% (91% to 99%)).

conclusionsWe highlight the low PPV for gonorrhoea of an unconfirmed reactive test when deploying molecular testing in a low-prevalence population. Failure to undertake confirmatory testing in low-prevalence settings may lead to inappropriate diagnoses, unnecessary treatment and overestimation of population prevalence.

Indexed as

AdolescentAdultChlamydia InfectionsChlamydia trachomatisFemaleGonorrheaHealth SurveysHumansLife StyleMaleMiddle AgedNeisseria gonorrhoeaeNucleic Acid Amplification TechniquesPopulation SurveillancePrevalenceRisk FactorsEPIDEMIOLOGY (CLINICAL)NEISSERIA GONORRHOEAPUBLIC HEALTHTESTING

Identifiers

PMID25512673
PMCPMC4518812
OpenAlexW2132252414

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.