Perceptions of an ideal point-of-care test for sexually transmitted infections--a qualitative study of focus group discussions with medical providers.
Perceptions of an ideal point-of-care test for sexually transmitted infections--a qualitative study of focus group discussions with medical providers.
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DOI：
10.1371/journal.pone.0014144
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发表时间：
2010-11-30
期刊：
影响因子：
3.7
通讯作者：
Gaydos CA
中科院分区：
文献类型：
--
作者：
Hsieh YH;Hogan MT;Barnes M;Jett-Goheen M;Huppert J;Rompalo AM;Gaydos CA
性传播感染(STI)的护理点检测(POCT)提供即时诊断，导致患者在一次就诊中接受诊断和治疗，有能力解决一些STI控制需求。然而，自从世界卫生组织性传播疾病诊断倡议15年前形成以来，性传播感染专家和最终用户对目前可用的性传播感染预防控制措施及其未来新发展的需求评估尚未得到评估。因此，我们的目标是探索在卫生保健环境中使用的理想类型的STI POCT的看法。2008年3月至2009年4月期间，进行了一项包括八个重点小组的定性研究。参与者包括6名性病诊所主任、63名临床医生和7名STI领域的公共卫生/实验室/流行病学专业人员。讨论的主题包括目前可用的POCT，在临床上使用POCT的公认障碍，开发新POCT的优先STI，以及理想POCT的特征。所有讨论都被逐字记录和转录。被认为是当前POCT的障碍的主题包括复杂性、所谓的“快速”测试的长时间框架、多个时间驱动的步骤、需要实验室技术人员、难以读取结果、工作流程中断、不可靠和侵入性。沙眼衣原体被确定为开发新的STI POCT的优先生物体。理想的POCT的主题包括快速周转(长达20分钟)、易用、非侵入性、准确(在高90度范围内首选的灵敏度和特异度)、临床实验室改进修正案(CLIA)-免除、用户友好(对患者和工作人员)、紧凑、耐用和坚固。与STI专家和专业人员的焦点小组讨论强调衣原体是POCT发展的首要病原体，并确定了用于STI的新POCT的质量。与会者赞同易用性、快速周转和高精确度是理想的POCT的基本特征。
A point-of-care test (POCT) for sexually transmitted infections (STIs), which offers immediate diagnosis resulting in patients receiving diagnosis and treatment in a single visit, has the ability to address some of the STI control needs. However, needs assessment from STI experts and end users about currently available STI POCTs and their future new development has not been evaluated since World Health Organization Sexually Transmitted Diseases Diagnostics Initiative was formed over 15 years ago. Therefore, our objective was to explore the perceptions of the ideal types of STI POCT for use in health care settings. A qualitative study, encompassing eight focus groups, was conducted from March 2008 through April 2009. Participants included 6 STD clinic directors, 63 clinicians, and 7 public health/laboratory/epidemiology professionals in the STI field. Discussion topics included currently available POCT, perceived barriers to using POCT in clinics, priority STI for the development of new POCT, and characteristics of the ideal POCT. All discussions were recorded and transcribed verbatim. Themes raised as barriers for current POCT included complexity, long time frames of the so-called “rapid” test, multiple time-driven steps, requiring laboratory technician, difficulty in reading result, interruption of workflow, unreliability, and invasiveness. Chlamydia trachomatis was identified as the priority organism for development of a new STI POCT. Themes indicated for the ideal POCT included rapid turnaround (up to 20 minutes), ease of use, non-invasive, accurate (preferred sensitivity and specificity in the range of high 90s), Clinical Laboratory Improvement Amendments (CLIA)-waived, user-friendly (for both patients and staff), compact, durable, and sturdy. Focus group discussions with STI experts and professionals highlighted chlamydia as the top priority pathogen for POCT development, and identified the qualities of new POCT for STIs. Participants endorsed ease of use, rapid turnaround and high accuracy as essential characteristics of an ideal POCT.
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