Screening for chlamydial infection: An evidence update for the US preventive services task force
Screening for chlamydial infection: An evidence update for the US preventive services task force
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DOI：
10.7326/0003-4819-147-2-200707170-00173
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发表时间：
2007-07-17
影响因子：
39.2
通讯作者：
Luckhaupt, Sara
中科院分区：
文献类型：
--
作者：
Meyers, David S.;Halvorson, Heather;Luckhaupt, Sara
背景资料：衣原体感染是美国最常见的性传播细菌感染，估计每年有300万新病例。在2001年，美国预防服务工作组（USPSTF）建议，临床医生筛选所有性活跃的妇女在增加感染沙眼衣原体的风险。目的：总结一个系统的证据审查委托USPSTF在准备更新其2001年recommendation.Data来源：英语语言的文章，确定在PubMed在2000年7月和2005年7月之间。通过书目审查和与专家讨论确定了其他文章。研究选择：对3个关键问题分别采用明确的纳入和排除标准。对于在非妊娠妇女中筛查风险增加的研究，审查仅限于随机对照试验。对于其他组，包括随机对照研究和非随机前瞻性对照研究。数据提取：使用标准化的表格，卫生保健研究机构和卫生部的工作人员提取研究设计，设置，样本，随机，盲法，结果和危害的数据。这项关于高危非孕妇衣原体感染筛查有效性的低质量研究发现，筛查与1年随访时衣原体感染患病率较低和盆腔炎报告病例较少相关。局限性：未发现孕妇、高危非孕妇或男性筛查的新证据。结论：一项系统性综述发现了少量新证据，可告知USPSTF更新其关于衣原体感染筛查的建议。关于筛查男性以改善女性健康状况的证据存在很大差距。
Background: Chlamydial infection is the most common sexually transmitted bacterial infection in the United States, with an estimated 3 million new cases annually. In 2001, the U.S. Preventive Services Task Force (USPSTF) recommended that clinicians screen all sexually active women at increased risk for infection for Chlamydia trachomatis.Purpose: To summarize a systematic evidence review commissioned by the USPSTF in preparation for an update of its 2001 recommendation.Data Sources: English-language articles identified in PubMed between July 2000 and July 2005. Additional articles were identified by bibliographic reviews and discussions with experts. A total of 452 articles were identified.Study Selection: Explicit inclusion and exclusion criteria were used for each of 3 key questions. For studies of screening in nonpregnant women at increased risk, review was limited to randomized, controlled trials. For other groups, both randomized, controlled studies and nonrandomized, prospective, controlled studies were included.Data Abstraction: Using standardized forms, staff of the Agency for Healthcare Research and Quaity abstracted data on study design, setting, sample, randomization, blinding, results, and harms.Data Synthesis: Only 1 new study met inclusion criteria. This poor-quality study of the effectiveness of screening for chlamydial infection among nonpregnant women at increased risk found that screening was associated with a lower prevalence of chlamydial infection and fewer reported cases of pelvic inflammatory disease at 1-year follow-up.Limitations: No new evidence was found on screening in pregnant women, nonpregnant women not at increased risk, or men.Conclusions: A systematic review found a small amount of new evidence to inform the USPSTF as it updates its recommendations regarding screening for chlamydial infection. There are large gaps in the evidence about screening men to improve health outcomes in women.