Evidence map›Paper›PMID 31193629›Full record

ArticleEClinicalMedicine

Predicting STI Diagnoses Amongst MSM and Young People Attending Sexual Health Clinics in England: Triage Algorithm Development and Validation Using Routine Clinical Data.

Carina King, Gwenda Hughes, Martina Furegato, Hamish Mohammed, John Were, Andrew Copas, Richard Gilson, Maryam Shahmanesh, Catherine H Mercer

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In one paragraph

Article in EClinicalMedicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 2 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

6 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
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  6. 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

9 authors.

Carina KingInstitute for Global Health, University College London, 30 Guilford Street, London, UK.
Gwenda HughesInstitute for Global Health, University College London, 30 Guilford Street, London, UK.
Martina FuregatoDepartment of HIV & STIs, Centre for Infectious Disease Surveillance & Control, Public Health England, 61 Colindale Avenue, London, UK.
Hamish MohammedInstitute for Global Health, University College London, 30 Guilford Street, London, UK.
John WereDepartment of HIV & STIs, Centre for Infectious Disease Surveillance & Control, Public Health England, 61 Colindale Avenue, London, UK.
Andrew CopasInstitute for Global Health, University College London, 30 Guilford Street, London, UK.
Richard GilsonInstitute for Global Health, University College London, 30 Guilford Street, London, UK.
Maryam ShahmaneshInstitute for Global Health, University College London, 30 Guilford Street, London, UK.
Catherine H MercerInstitute for Global Health, University College London, 30 Guilford Street, London, UK.

Funding

Department of Health 12/191/05Department of Health HTA/12/191/05
6 · The paper itself

Abstract

backgroundSexual health (SH) services increasingly need to prioritise those at greatest risk of sexually transmitted infections (STIs). We used SH surveillance data to develop algorithms to triage individuals attending SH services within two high-risk populations: men who have sex with men (MSM) and young people (YP).

methodsSeparate multivariable logistic regression models for MSM and YP were developed using surveillance data on demographics, recent sexual history, prior STI diagnoses and drug/alcohol use from five clinics in 2015-2016 to identify factors associated with new STI diagnoses. The models were prospectively applied in one SH clinic in May 2017 as an external validation.

findings9530 YP and 1448 MSM SH episodes informed model development. For YP, factors associated with new STI diagnosis (overall prevalence: 10.6%) were being of black or mixed white/black ethnicity; history of chlamydia diagnosis (previous year); and multiple partners/new partner (previous 3-months). The YPs model had reasonable performance (c-statistic: 0.703), but poor discrimination when externally validated (c-statistic: 0.539). For MSM, being of South Asian ethnicity; being born in Europe (excluding the UK); and condomless anal sex or drug use (both in previous 3-months) were associated with STI diagnosis (overall prevalence: 22.0%). The MSM model had a c-statistic of 0.676, reducing to 0.579 on validation.

interpretationSH surveillance data, including limited behavioural data, enabled triage algorithms to be developed, but its implementation may be problematic due to poor external performance. This approach may be more suitable to self-triage, including online, ensuring patients are directed towards appropriate services.

fundingNIHR HTA programme (12/191/05).

Indexed as

MSMPredictive modelRoutine dataSTITriageYoung people

Identifiers

PMID31193629
PMCPMC6537562

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Registered trials

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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.