Evidence map›Paper›PMID 38952441›Full record

ArticleThe Lancet regional health. Western Pacific2024

Clinical effectiveness and analytical quality of a national point-of-care testing network for sexually transmitted infections integrated into rural and remote primary care clinics in Australia, 2016-2022: an observational program evaluation.

Louise M Causer, James Ward, Kirsty Smith, Amit Saha, Kelly Andrewartha, Handan Wand, Belinda Hengel, Steven G Badman, Annie Tangey, Susan Matthews and 15 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Lancet regional health. Western Pacific, 2024. 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
–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

3 citing papers in PubMed.

  1. Article
  2. Review
  3. 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

25 authors.

Louise M CauserKirby Institute, UNSW Sydney, New South Wales, Australia.
James WardPoche Centre for Indigenous Health, The University of Queensland, Queensland, Australia.
Kirsty SmithKirby Institute, UNSW Sydney, New South Wales, Australia.
Amit SahaKirby Institute, UNSW Sydney, New South Wales, Australia.
Kelly AndrewarthaFlinders University International Centre for Point of Care Testing, South Australia, Australia.
Handan WandKirby Institute, UNSW Sydney, New South Wales, Australia.
Belinda HengelKirby Institute, UNSW Sydney, New South Wales, Australia.
Steven G BadmanKirby Institute, UNSW Sydney, New South Wales, Australia.
Annie TangeyKirby Institute, UNSW Sydney, New South Wales, Australia.
Susan MatthewsFlinders University International Centre for Point of Care Testing, South Australia, Australia.
Donna MakWA Health, Western Australia, Australia.
Manoji GunathilakeNT Health, Northern Territory, Australia.
Elizabeth MooreAboriginal Medical Services Alliance of Northern Territory, Darwin, Northern Territory, Australia.
David SpeersPathWest, Western Australia, Australia.
David PersingCepheid, California, USA.
David AndersonBurnet Institute, Victoria, Australia.
David WhileyCentre for Clinical Research, University of Queensland, Australia.
Lisa MaherKirby Institute, UNSW Sydney, New South Wales, Australia.
David ReganKirby Institute, UNSW Sydney, New South Wales, Australia.
Basil DonovanKirby Institute, UNSW Sydney, New South Wales, Australia.
Christopher FairleyMelbourne Sexual Health Centre, Melbourne, Victoria, Australia.
John KaldorKirby Institute, UNSW Sydney, New South Wales, Australia.
Mark ShephardFlinders University International Centre for Point of Care Testing, South Australia, Australia.
Rebecca GuyKirby Institute, UNSW Sydney, New South Wales, Australia.
TTANGO2 Collaboration

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: To address inequitable diagnostic access and improve time-to-treatment for First Nations peoples, molecular point-of-care (POC) testing for chlamydia, gonorrhoea and trichomonas was integrated into 49 primary care clinics across Australia. We conducted an observational evaluation to determine clinical effectiveness and analytical quality of POC testing delivered through this national program. Methods: We evaluated (i) implementation by measuring trends in mean monthly POC testing; ii) clinical effectiveness by comparing proportions of positive patients treated by historical control/intervention period and by test type, and calculated infectious days averted; (iii) analytical quality by calculating result concordance by test type, and proportion of unsuccessful POC tests. Findings: Between 2016 and 2022, 46,153 POC tests were performed; an increasing mean monthly testing trend was observed in the first four years (p < 0.0001). A greater proportion of chlamydia/gonorrhoea positives were treated in intervention compared with historical control periods (≤2 days: 37% vs 22% [RR 1.68; 95% CI 1.12, 2.53]; ≤7 days: 48% vs 30% [RR 1.6; 95% CI 1.10, 2.33]; ≤120 days: 79% vs 54% [RR 1.46; 95% CI 1.10, 1.95]); similarly for trichomonas positives and by test type. POC testing for chlamydia, gonorrhoea and trichomonas averted 4930, 5620 and 7075 infectious days, respectively. Results concordance was high [99.0% (chlamydia), 99.3% (gonorrhoea) and 98.9% (trichomonas)]; unsuccessful POC test proportion was 1.8% for chlamydia/gonorrhoea and 2.1% for trichomonas. Interpretation: Molecular POC testing was successfully integrated into primary care settings as part of a routinely implemented program achieving significant clinical benefits with high analytical quality. In addition to the individual health benefits of earlier treatment, fewer infective days could contribute to reduced transmissions in First Nations communities. Funding: This work was supported by an Australian National Health and Medical Research Council Partnership Grant (APP1092503), the Australian Government Department of Health, Western Australia and Queensland Departments of Health.

Indexed as

ChlamydiaClinical effectivenessGonorrhoeaImplementationPOC testingScaling upSexually transmitted infectionsTrichomoniasis

Identifiers

PMID38952441
PMCPMC11215331

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.