Evidence map›Paper›PMID 28199392›Full record

SynthesisPloS one2017

Comparison of the population excess fraction of Chlamydia trachomatis infection on pelvic inflammatory disease at 12-months in the presence and absence of chlamydia testing and treatment: Systematic review and retrospective cohort analysis.

Bethan Davies, Katy M E Turner, Stella Leung, B Nancy Yu, Maria Frølund, Thomas Benfield, James Blanchard, Henrik Westh, Danish Chlamydia Study, Helen Ward

Open access · goldAbstract readSystematic Review
In one paragraph

Synthesis in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
0.7field-weighted citation impact, top 32% 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

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.

  1. Sexually transmitted infections · 2019
    Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
  6. Review
  7. Article
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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 at 6 institutions in 3 countries.

Bethan DaviesDepartment of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, United Kingdom.ORCID http://orcid.org/0000-0002-6585-7641
Katy M E TurnerSchool of Veterinary Science, University of Bristol, Langford, Bristol, United Kingdom.
Stella LeungDepartment of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
B Nancy YuDepartment of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
Maria FrølundDepartment of Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark.
Thomas BenfieldDepartment of Infectious Diseases, Hvidovre University Hospital, Hvidovre, Denmark.
James BlanchardDepartment of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
Henrik WesthInstitute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Danish Chlamydia Study
Helen WardDepartment of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, United Kingdom.
Imperial College London · GBUniversity of Copenhagen · DKUniversity of Manitoba · CAManitoba Health · CAStatens Serum Institut · DKUniversity of Bristol · GB

Funding

UGI HEMORRHAGE AND BARRETTS EPITHELIUMK24DK002650 · NIDDK · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI JENSEN, DENNIS MICHAEL · 1999 to 2008
$1.1M
Medical Research Council G0902120NIDDK NIH HHS K24 DK002650Wellcome Trust
6 · The paper itself

Abstract

backgroundThe impact of Chlamydia trachomatis (chlamydia) control on the incidence of pelvic inflammatory disease (PID) is theoretically limited by the proportion of PID caused by chlamydia. We estimate the population excess fraction (PEF) of treated chlamydia infection on PID at 12-months in settings with widespread chlamydia control (testing and treatment) and compare this to the estimated PEF of untreated chlamydia.

methodsWe used two large retrospective population-based cohorts of women of reproductive age from settings with widespread chlamydia control to calculate the PEF of treated chlamydia on PID at 12-months. We undertook a systematic review to identify further studies that reported the risk of PID in women who were tested for chlamydia (infected and uninfected). We used the same method to calculate the PEF in eligible studies then compared all estimates of PEF.

resultsThe systematic review identified a single study, a randomised controlled trial of chlamydia screening (POPI-RCT). In the presence of testing and treatment <10% of PID at 12-months was attributable to treated (baseline) chlamydia infections (Manitoba: 8.86%(95%CI 7.15-10.75); Denmark: 3.84%(3.26-4.45); screened-arm POPI-RCT: 0.99%(0.00-29.06)). In the absence of active chlamydia treatment 26.44%(11.57-46.32) of PID at 12-months was attributable to untreated (baseline) chlamydia infections (deferred-arm POPI-RCT). The PEFs suggest that eradicating baseline chlamydia infections could prevent 484 cases of PID at 12-months per 100,000 women in the untreated setting and 13-184 cases of PID per 100,000 tested women in the presence of testing and treatment.

conclusionTesting and treating chlamydia reduced the PEF of chlamydia on PID by 65% compared to the untreated setting. But in the presence of testing and treatment over 90% of PID could not be attributed to a baseline chlamydia infection. More information is needed about the aetiology of PID to develop effective strategies for improving the reproductive health of women.

Indexed as

Chlamydia InfectionsChlamydia trachomatisClinical Trials as TopicFemaleHumansPelvic Inflammatory DiseasePrevalenceRetrospective StudiesRisk

Identifiers

PMID28199392
PMCPMC5310913
OpenAlexW2589946937

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.