Evidence map›Paper›PMID 35184344›Full record

ArticleAcademic emergency medicine : official journal of the Society for Academic Emergency Medicine2022

Impact of risk-based sexually transmitted infection screening in the emergency department.

Fahd A Ahmad, Kayleigh Fischer, Hongjie Gu, Thomas C Bailey, Donna B Jeffe, Christopher R Carpenter, Philip R O Payne

Open access · greenAbstract read
In one paragraph

Article in Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.9field-weighted citation impact, top 14% 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

3 citing papers in PubMed, 8 citations in OpenAlex.

  1. 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

7 authors at 2 institutions in 1 country.

Fahd A AhmadDepartment of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA.ORCID 0000-0001-5919-6835
Kayleigh FischerDepartment of Emergency Medicine, Children's Memorial Hermann Hospital, University of Texas Health Science Center, Houston, Texas, USA.ORCID 0000-0002-7394-3048
Hongjie GuDivision of Biostatistics, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA.
Thomas C BaileyDepartment of Medicine, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA.
Donna B JeffeDepartment of Medicine, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA.ORCID 0000-0002-7642-3777
Christopher R CarpenterDepartment of Emergency Medicine, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA.ORCID 0000-0002-2603-7157
Philip R O PayneInstitute for Informatics, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA.
Washington University in St. Louis · USMemorial Hermann · US

Funding

Washington University Institute of Clinical and Translational Sciences (KL2) KL2TR002346 · NCATS · WASHINGTON UNIVERSITY · PI Dominic N Reeds · 2017 to 2026
$14.0M
NCATS NIH HHS KL2 TR002346
6 · The paper itself

Abstract

objectivesSexually transmitted infections (STIs), including chlamydia, gonorrhea, and human immunodeficiency virus (HIV) pose a significant health burden in adolescents. Many adolescents receiving care in the emergency department (ED) are in need of testing, regardless of their chief complaint. Our objective was to determine whether an electronic, risk-based STI screening program in our ED was associated with an increase in STI testing among at-risk adolescents.

methodsWe conducted a retrospective cohort analysis of patient outcomes in our pediatric ED after integrating an Audio-enhanced Computer-Assisted Self-Interview (ACASI) as standard of care. It obtained a focused sexual history and generated STI testing recommendations. Patient answers and testing recommendations were integrated in real-time into the electronic health record. Patients who tested positive received treatment according to our standard-of-care practices. All patients 15-21 years of age were asked to complete this on an opt-out basis, regardless of the reason for their ED visit. Exclusions included those unable to independently use a tablet, severe illness, sexual assault, or non-English speaking. Our primary outcome was to describe STI-testing recommendations and test results among ACASI participants. We also compared STI testing between ACASI participants and those who were eligible but did not use it.

resultsIn the first 13 months, 28.9% (1788/6194) of eligible adolescents completed the ACASI and 44.2% (321/790) accepted recommended STI testing. The mean age of participants was 16.6 ± 1.3 years, with 65.4% (1169) being female. Gonorrhea/chlamydia testing was significantly higher among participants vs. non-participants (20.1% [359/1788] vs 4.8% [212/4406]; p < 0.0001). The proportion of positive STI tests was similar between the two groups: 24.8% (89/359) vs. 24.5% (52/212; p = 0.94) were positive for chlamydia and/or gonorrhea, while 0.6% (2/354) participants vs. 0% non-participants (p > 0.99) were positive for HIV. Among participants whose chief complaints were unlikely to be related to STIs but accepted recommended testing, 20.9% (37/177) were positive for gonorrhea or chlamydia.

conclusionsOur program facilitated STI testing in the ED and identified many adolescents with STIs, even when their ED complaint was for unrelated reasons. More rigorous implementation is needed to determine the impact of deployment of ACASI to all eligible adolescents and addressing barriers to accepting STI testing recommendations.

Indexed as

Chlamydia InfectionsGonorrheaHIV InfectionsSexually Transmitted DiseasesAdolescentChildEmergency Service, HospitalFemaleHumansMaleMass ScreeningRetrospective Studies

Identifiers

PMID35184344
PMCPMC10648282
OpenAlexW4212908041

What OpenQuestion holds

Textmetadata
LicenceTDM
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.