Evidence map›Paper›PMID 29247095›Full record

ArticleBMJ open2017

Effectiveness and cost-effectiveness of implementing HIV testing in primary care in East London: protocol for an interrupted time series analysis.

Werner Leber, Lee Beresford, Claire Nightingale, Estela Capelas Barbosa, Stephen Morris, Farah El-Shogri, Heather McMullen, Kambiz Boomla, Valerie Delpech, Alison Brown and 11 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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

2 citing papers in PubMed.

  1. Trial
  2. 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

21 authors.

Werner LeberCentre for Primary Care and Public Health, Queen Mary University of London, London, UK.
Lee BeresfordCentre for Primary Care and Public Health, Queen Mary University of London, London, UK.
Claire NightingalePopulation Health Research Institute, St George's, University of London, London, UK.
Estela Capelas BarbosaDepartment of Applied Health Research, University College London, London, UK.
Stephen MorrisDepartment of Applied Health Research, University College London, London, UK.
Farah El-ShogriCentre for Primary Care and Public Health, Queen Mary University of London, London, UK.
Heather McMullenCentre for Primary Care and Public Health, Queen Mary University of London, London, UK.
Kambiz BoomlaCentre for Primary Care and Public Health, Queen Mary University of London, London, UK.
Valerie DelpechDepartment of HIV and STI, National Infection Service, Public Health England, London, UK.
Alison BrownDepartment of HIV and STI, National Infection Service, Public Health England, London, UK.
Jane HutchinsonBarts Sexual Health Centre, Barts Health NHS Trust, London, UK.
Vanessa ApeaBarts Sexual Health Centre, Barts Health NHS Trust, London, UK.
Merle SymondsBarts Sexual Health Centre, Barts Health NHS Trust, London, UK.
Samantha GillihamBarts Sexual Health Centre, Barts Health NHS Trust, London, UK.
Sarah CreightonCentre for Sexual Health, Homerton University Hospital NHS Foundation Trust, London, UK.
Maryam ShahmaneshDepartment of Applied Health Research, University College London, London, UK.
Naomi FulopDepartment of Applied Health Research, University College London, London, UK.
Claudia EstcourtBarts Sexual Health Centre, Barts Health NHS Trust, London, UK.
Jane AndersonCentre for Sexual Health, Homerton University Hospital NHS Foundation Trust, London, UK.
Jose FigueroaSpecialised Commissioning Team, NHS England, London, UK.
Chris GriffithsCentre for Primary Care and Public Health, Queen Mary University of London, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionHIV remains underdiagnosed. Guidelines recommend routine HIV testing in primary care, but evidence on implementing testing is lacking. In a previous study, the Rapid HIV Assessment 2 (RHIVA2) cluster randomised controlled trial, we showed that providing training and rapid point-of-care HIV testing at general practice registration (RHIVA2 intervention) in Hackney led to cost-effective, increased and earlier diagnosis of HIV. However, interventions effective in a trial context may be less so when implemented in routine practice. We describe the protocol for an MRC phase IV implementation programme, evaluating the impact of rolling out the RHIVA2 intervention in a post-trial setting. We will use a longitudinal study to examine if the post-trial implementation in Hackney practices is effective and cost-effective, and a cross-sectional study to compare Hackney with two adjacent boroughs providing usual primary care (Newham) and an enhanced service promoting HIV testing in primary care (Tower Hamlets). METHODS AND ANALYSIS: Service evaluation using interrupted time series and cost-effectiveness analyses. We will include all general practices in three contiguous high HIV prevalence East London boroughs. All adults aged 16 and above registered with the practices will be included. The interventions to be examined are: a post-trial RHIVA2 implementation programme (including practice-based education and training, external quality assurance, incentive payments for rapid HIV testing and incorporation of rapid HIV testing in the sexual health Local Enhanced Service) in Hackney; the general practice sexual health Network Improved Service in Tower Hamlets and usual care in Newham. Coprimary outcomes are rates of HIV testing and new HIV diagnoses. ETHICS AND DISSEMINATION: The chair of the Camden and Islington NHS Research Ethics Committee, London, has endorsed this programme as an evaluation of routine care. Study results will be published in peer-reviewed journals and reported to commissioners.

Indexed as

Cost-Benefit AnalysisCross-Sectional StudiesEarly DiagnosisFemaleGeneral PracticeHIV InfectionsHumansInterrupted Time Series AnalysisLondonLongitudinal StudiesMaleMass ScreeningPrimary Health CareRegression AnalysisResearch Designcost-effectivenessHIVHIV diagnosisHIV screeningHIV testingimplementationinterrupted time series

Identifiers

PMID29247095
PMCPMC5735409

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.