Evidence map›Paper›PMID 34175944›Full record

Trial reportClinical infectious diseases : an official publication of the Infectious Diseases Society of America2022

Routinized Syphilis Screening Among Men Living With Human Immunodeficiency Virus: A Stepped Wedge Cluster Randomized Controlled Trial.

Ann N Burchell, Darrell H S Tan, Ramandip Grewal, Paul A MacPherson, Sharon Walmsley, Anita Rachlis, Nisha Andany, Sharmistha Mishra, Sandra L Gardner, Janet Raboud and 9 more

Registry-linked trialOpen access · greenAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02019043 (Enhanced Syphilis Screening Among HIV-positive Men), which is not on this map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
0.8field-weighted citation impact, top 28% 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.

NCT02019043 nacompletednot on this map

Enhanced Syphilis Screening Among HIV-positive Men (ESSAHM): Evaluation of a Clinic-based Intervention

TypeinterventionalSponsorUnity Health TorontoRan2015 to 2017Enrolled3,895ConditionsSyphilisArmsSyphilis testing with routine HIV bloodwork
3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 8 citations in OpenAlex.

  1. Review
  2. 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

19 authors at 8 institutions in 1 country.

Ann N BurchellDepartment of Family and Community Medicine, St Michael's Hospital, Unity Health, Toronto, Toronto, Ontario, Canada.
Darrell H S TanMAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.
Ramandip GrewalMAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.
Paul A MacPhersonDivision of Infectious Diseases, The Ottawa Hospital, Ottawa, Ontario, Canada.
Sharon WalmsleyDepartment of Medicine, University of Toronto, Toronto, Ontario, Canada.
Anita RachlisDepartment of Medicine, University of Toronto, Toronto, Ontario, Canada.
Nisha AndanyDepartment of Medicine, University of Toronto, Toronto, Ontario, Canada.
Sharmistha MishraMAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.
Sandra L GardnerBaycrest, Toronto, Ontario, Canada.
Janet RaboudToronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada.
David FismanDalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Curtis CooperOttawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Ontario, Canada.
Kevin GoughDepartment of Medicine, University of Toronto, Toronto, Ontario, Canada.
John MaxwellACT, Toronto, Ontario, Canada.
Sean B RourkeMAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.
Rodney RousseauDepartment of Immunology, University of Toronto, Toronto, Ontario, Canada.
Tony MazzulliMount Sinai Hospital, Toronto, Ontario, Canada.
Irving E SalitToronto General Hospital, University Health Network, Toronto, Ontario, Canada.
Vanessa G AllenPublic Health Ontario Laboratories, Public Health Ontario, Toronto, Ontario, Canada.
University of Toronto · CAUnity Health TorontoMount Sinai Hospital · CAOttawa Hospital Research InstituteSt. Michael's Hospital · CAToronto General Hospital · CAToronto Public Health · CAUniversity of Ottawa · CA

Funding

CIHR MOP 130440CIHR Canadian HIV Trials Network CTN-275
6 · The paper itself

Abstract

backgroundWe implemented an opt-out clinic-based intervention pairing syphilis tests with routine human immunodeficiency virus (HIV) viral load testing. The primary objective was to determine the degree to which this intervention increased the detection of early syphilis.

methodsThe Enhanced Syphilis Screening Among HIV-Positive Men (ESSAHM) Trial was a stepped wedge cluster-randomized controlled trial involving 4 urban HIV clinics in Ontario, Canada, from 2015 to 2017. The population was HIV-positive adult males. The intervention was standing orders for syphilis serological testing with viral loads, and control was usual practice. We obtained test results via linkage with the centralized provincial laboratory and defined cases using a standardized clinical worksheet and medical record review. We employed a generalized linear mixed model with a logit link to estimate odds ratios (ORs) and 95% confidence intervals (CIs) of the intervention.

resultsA total of 3895 men were followed over 7471 person-years. The mean number of syphilis tests increased from 0.53 to 2.02 tests per person per year. There were 217 new diagnoses of syphilis (control, 81; intervention, 136), for which 147 (68%) were cases of early syphilis (control, 61 [75%]; intervention, 86 [63%]). The annualized proportion with newly detected early syphilis increased from 0.009 to 0.032 with implementation of the intervention; the corresponding time-adjusted OR was 1.25 (95% CI, .71-2.20).

conclusionsThe implementation of standing orders for syphilis testing with HIV viral loads was feasible and increased testing, yet produced less-than-expected increases in case detection compared to past uncontrolled pre-post trials. CLINICAL TRIALS REGISTRATION: NCT02019043.

Indexed as

HIV InfectionsSyphilisAdultHIVHumansMaleMass ScreeningOntariocluster-randomized controlled trialHIVinterventionmenoutpatient clinicsscreeningsyphilis

Identifiers

PMID34175944
PMCPMC8906680
OpenAlexW3176476847

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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.