The importance of striving for greater efficiency

Fairley, Christopher K.; Vodstrcil, Lenka A; Read, Tim

doi:10.1071/sh10059

Cited by 9 publications

(9 citation statements)

References 13 publications

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“…The provision of a risk quiz to the IWTK home collection programme was added to encourage participants to take a look at their own risk for having an STI, perhaps with gaining knowledge as to their own risk. Self-management of one's own reproductive health is becoming more popular; and improvement in the efficiency and delivery of sexual health care with a focus on innovation may popularise ‘Do it yourself’ sexual healthcare 17. Baraitser et al 18 have reported on the user experience for patients collecting their own samples, reporting that “clients were grateful for the service and preferred the autonomy, privacy and speed that their programme offered”.…”

Section: Discussionmentioning

confidence: 99%

Use of a risk quiz to predict infection for sexually transmitted infections: a retrospective analysis of acceptability and positivity

et al. 2015

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Background Individuals who are sexually active may want to make a decision as to whether they are at risk for having a sexually transmitted infection (STI) such as Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis. Our goal was to develop and evaluate a simple self-taken sexual risk quiz for participants, ordering an online STI self-collection test kit to determine whether the score predicted infection status. Methods As part of the IWantTheKit programme for home sample self-collection for STIs, 2010–2013, the programme asked male and female users to voluntarily take a risk quiz. The six-question quiz was about risk behaviour and included an age question. Data analyses were stratified by gender as determined a priori. Scores 0–10 were stratified into risk groups for each gender based on similar risk score-specific STI prevalence. Retrospective analyses were performed to assess whether risk group predicted aggregate STI positivity. Urogenital/rectal mailed samples were tested by nucleic acid amplification tests. Results More females (N=836) than males (N=558) provided voluntary risk scores. The percentage of eligible participants who submitted scores was 43.9% for both females and males. There was a higher STI infection rate in females (14.0%) than in males (7.0%) for having any STI (p<0.001). Multivariate logistic analysis for females, which controlled for age and race, demonstrated that a higher risk score group independently predicted risk for having an STI (OR of 2.2 for risk scores 5–7 and 4.2 OR for scores of 8–10). For males, the multivariate model, which controlled for race, indicated that no risk score group was associated having an STI. Conclusions Results of a participant’s own sexual risk quiz score independently predicted STI positivity for women, but not for men. Further study of this simple risk quiz is required.

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Section: Discussionmentioning

confidence: 99%

Use of a risk quiz to predict infection for sexually transmitted infections: a retrospective analysis of acceptability and positivity

et al. 2015

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“…[1][2][3] Providing access to services for symptomatic individuals reduces the duration of infectiousness and screening high-risk asymptomatic individuals also decreases the duration of infectiousness. Our clinic has experienced increase demand in recent years with rising rates of chlamydia (Chlamydia trachomatis), gonorrhoea (Neisseria gonorrhoeae), syphilis and HIV.…”

Section: Introductionmentioning

confidence: 99%

“…4 Several different strategies have been used to improve clinic efficiency and improve access to clinical services. 3 One of these was an express service for lower risk heterosexuals.…”

Section: Introductionmentioning

confidence: 99%

An evaluation of an express testing service for sexually transmissible infections in low-risk clients without complications

Gamagedara¹,

Dobinson²,

Cummings³

et al. 2014

Sex. Health

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Abstract. Background: One effective way of reducing the prevalence of sexually transmissible infections (STIs) in a population is ensuring easy access to clinical services and screening of populations at high risk of STIs, including HIV. We aimed to describe the features of clients using the express testing service (ETS) and the overall impact on the service. Methods: This retrospective cross-sectional study involved all clients attending the walk-in triage service at Melbourne Sexual Health Centre before the introduction of ETS in 2009 and after ETS (2011 and2012). Results: There were 32 720 and 82 265 consultations before and after ETS respectively. The ETS saw 4387 (9%) of 55 648 consultations (excluding appointments and results), giving rise to a fall in the proportion of lower-risk clients having full consultations (from 53% to 50% of consultations; P < 0.001). The consultations testing for HIV and chlamydia (Chlamydia trachomatis) were marginally higher (HIV: 48% v. 47%, P = 0.017; chlamydia: 70% v. 68%, P = 0.015) with ETS. Young (26 v. 27 years) females (38% v. 34%) utilised the ETS more (P < 0.001). The time taken for consultation and the total time spent in the clinic was significantly decreased during the ETS period (from 25 min to 6 min for consultation time and from 59 min to 29 min for total clinic time; P < 0.001). Conclusions: The data suggest that fast-track services such as ETS are effective in increasing access for higher-risk individuals while streamlining screening of asymptomatic low-risk clients.

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“…There has been considerable interest in the adoption of information and communication technology for prioritizing resources in sexually transmitted infections (STI) service delivery [1,2]. In British Columbia (BC), we are developing Get Checked Online (GCO), an Internet-based testing program that provides Web-based access to STI testing [3].…”

Section: Introductionmentioning

confidence: 99%

Risk Prediction in Sexual Health Contexts: Protocol

Falasinnu¹,

Gustafson²,

Gilbert³

et al. 2013

JMIR Res Protoc

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BackgroundIn British Columbia (BC), we are developing Get Checked Online (GCO), an Internet-based testing program that provides Web-based access to sexually transmitted infections (STI) testing. Much is still unknown about how to implement risk assessment and recommend tests in Web-based settings. Prediction tools have been shown to successfully increase efficiency and cost-effectiveness of STI case finding in the following settings.ObjectiveThis project was designed with three main objectives: (1) to derive a risk prediction rule for screening chlamydia and gonorrhea among clients attending two public sexual health clinics between 2000 and 2006 in Vancouver, BC, (2) to assess the temporal generalizability of the prediction rule among more recent visits in the Vancouver clinics (2007-2012), and (3) to assess the geographical generalizability of the rule in seven additional clinics in BC.MethodsThis study is a population-based, cross-sectional analysis of electronic records of visits collected at nine publicly funded STI clinics in BC between 2000 and 2012. We will derive a risk score from the multivariate logistic regression of clinic visit data between 2000 and 2006 at two clinics in Vancouver using newly diagnosed chlamydia and gonorrhea infections as the outcome. The area under the receiver operating characteristic curve (AUC) and the Hosmer-Lemeshow statistic will examine the model’s discrimination and calibration, respectively. We will also examine the sensitivity and proportion of patients that would need to be screened at different cutoffs of the risk score. Temporal and geographical validation will be assessed using patient visit data from more recent visits (2007-2012) at the Vancouver clinics and at clinics in the rest of BC, respectively. Statistical analyses will be performed using SAS, version 9.3.ResultsThis is an ongoing research project with initial results expected in 2014.ConclusionsThe results from this research will have important implications for scaling up of Internet-based testing in BC. If a prediction rule with good calibration, discrimination, and high sensitivity to detect infection is found during this project, the prediction rule could be programmed into GCO so that the program offers individualized testing recommendations to clients. Further, the prediction rule could be adapted into educational materials to inform other Web-based content by creating awareness about STI risk factors, which may stimulate health care seeking behavior among individuals accessing the website.

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The importance of striving for greater efficiency

Cited by 9 publications

References 13 publications

Use of a risk quiz to predict infection for sexually transmitted infections: a retrospective analysis of acceptability and positivity

Use of a risk quiz to predict infection for sexually transmitted infections: a retrospective analysis of acceptability and positivity

An evaluation of an express testing service for sexually transmissible infections in low-risk clients without complications

Risk Prediction in Sexual Health Contexts: Protocol

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