A Computerized Sexual Health Survey Improves Testing for Sexually Transmitted Infection in a Pediatric Emergency Department.
A Computerized Sexual Health Survey Improves Testing for Sexually Transmitted Infection in a Pediatric Emergency Department.
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DOI：
10.1016/j.jpeds.2016.12.045
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发表时间：
2017-04
期刊：
影响因子：
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通讯作者：
Chamberlain JM
中科院分区：
文献类型：
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作者：
Goyal MK;Fein JA;Badolato GM;Shea JA;Trent ME;Teach SJ;Zaoutis TE;Chamberlain JM
Adolescents have the highest rates of sexually transmitted infections (STIs) and often use the emergency department (ED) for care, making the ED a strategic setting for STI screening. We studied if clinical decision support, using computerized STI risk assessments, results in increased STI testing of adolescents at high risk for STI. In a 2-arm randomized controlled trial conducted at a single, urban, pediatric ED, adolescents completed a computerized sexual health survey (SHS). For patients assigned to the intervention arm, attending physicians received decision support to guide STI testing based on the SHS-derived STI risk; in the usual care arm decision support was not provided. We compared STI testing rates between the intervention and usual care groups, adjusting for potential confounding using multivariable logistic regression. 635 of 728 (87.2%) enrolled patients had evaluable data (323 intervention arm; 312 usual care arm). STI testing frequency was higher in the intervention group when compared to the usual care group (52.3% vs. 42.0%; aOR 2.0 [95% CI 1.1, 3.8]). This effect was even more pronounced among the patients who presented asymptomatic for STI (28.6 vs. 8.2%; aOR 4.7 [95% CI 1.4, 15.5]). Providing SHS-derived decision support to ED clinicians led to increased STI testing rates in adolescents at high risk for infection, particularly in those presenting asymptomatic for infection. Studies to understand potential barriers to decision support adherence should be undertaken to inform larger, multicenter studies to determine the generalizability of these findings and whether this process leads to increased STI detection.
