A Computerized Sexual Health Survey Improves Testing for Sexually Transmitted Infection in a Pediatric Emergency Department

Monika K. Goyal, Joel A. Fein, Gia M. Badolato, Judy A. Shea, Maria E Trent, Stephen J. Teach, Theoklis E. Zaoutis, James M. Chamberlain

Research output: Contribution to journalArticle

Abstract

Objectives: To assess whether clinical decision support, using computerized sexually transmitted infection (STI) risk assessments, results in increased STI testing of adolescents at high risk for STI. Study design: In a 2-arm, randomized, controlled trial conducted at a single, urban, pediatric emergency department, adolescents completed a computerized sexual health survey. For patients assigned to the intervention arm, attending physicians received decision support to guide STI testing based on the sexual health survey-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. Results: Of the 728 enrolled patients, 635 (87.2%) had evaluable data (323 intervention arm; 312 usual care arm). STI testing frequency was higher in the intervention group compared with the usual care group (52.3% vs 42%; aOR 2 [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]). Conclusions: Providing sexual health survey-derived decision support to emergency department clinicians led to increased testing rates for STI 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 that could determine the generalizability of these findings and whether this process leads to increased STI detection. Trial registration: ClinicalTrials.gov: NCT02509572.

Original languageEnglish (US)
JournalJournal of Pediatrics
DOIs
StateAccepted/In press - Aug 4 2016

Fingerprint

Reproductive Health
Sexually Transmitted Diseases
Health Surveys
Hospital Emergency Service
Pediatrics
Clinical Decision Support Systems
Asymptomatic Infections
Multicenter Studies
Randomized Controlled Trials
Logistic Models
Physicians

Keywords

  • Adolescent

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

A Computerized Sexual Health Survey Improves Testing for Sexually Transmitted Infection in a Pediatric Emergency Department. / Goyal, Monika K.; Fein, Joel A.; Badolato, Gia M.; Shea, Judy A.; Trent, Maria E; Teach, Stephen J.; Zaoutis, Theoklis E.; Chamberlain, James M.

In: Journal of Pediatrics, 04.08.2016.

Research output: Contribution to journalArticle

Goyal, Monika K. ; Fein, Joel A. ; Badolato, Gia M. ; Shea, Judy A. ; Trent, Maria E ; Teach, Stephen J. ; Zaoutis, Theoklis E. ; Chamberlain, James M. / A Computerized Sexual Health Survey Improves Testing for Sexually Transmitted Infection in a Pediatric Emergency Department. In: Journal of Pediatrics. 2016.
@article{c00807d9f90246e58242f6431f50327a,
title = "A Computerized Sexual Health Survey Improves Testing for Sexually Transmitted Infection in a Pediatric Emergency Department",
abstract = "Objectives: To assess whether clinical decision support, using computerized sexually transmitted infection (STI) risk assessments, results in increased STI testing of adolescents at high risk for STI. Study design: In a 2-arm, randomized, controlled trial conducted at a single, urban, pediatric emergency department, adolescents completed a computerized sexual health survey. For patients assigned to the intervention arm, attending physicians received decision support to guide STI testing based on the sexual health survey-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. Results: Of the 728 enrolled patients, 635 (87.2{\%}) had evaluable data (323 intervention arm; 312 usual care arm). STI testing frequency was higher in the intervention group compared with the usual care group (52.3{\%} vs 42{\%}; aOR 2 [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]). Conclusions: Providing sexual health survey-derived decision support to emergency department clinicians led to increased testing rates for STI 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 that could determine the generalizability of these findings and whether this process leads to increased STI detection. Trial registration: ClinicalTrials.gov: NCT02509572.",
keywords = "Adolescent",
author = "Goyal, {Monika K.} and Fein, {Joel A.} and Badolato, {Gia M.} and Shea, {Judy A.} and Trent, {Maria E} and Teach, {Stephen J.} and Zaoutis, {Theoklis E.} and Chamberlain, {James M.}",
year = "2016",
month = "8",
day = "4",
doi = "10.1016/j.jpeds.2016.12.045",
language = "English (US)",
journal = "Journal of Pediatrics",
issn = "0022-3476",
publisher = "Mosby Inc.",

}

TY - JOUR

T1 - A Computerized Sexual Health Survey Improves Testing for Sexually Transmitted Infection in a Pediatric Emergency Department

AU - Goyal, Monika K.

AU - Fein, Joel A.

AU - Badolato, Gia M.

AU - Shea, Judy A.

AU - Trent, Maria E

AU - Teach, Stephen J.

AU - Zaoutis, Theoklis E.

AU - Chamberlain, James M.

PY - 2016/8/4

Y1 - 2016/8/4

N2 - Objectives: To assess whether clinical decision support, using computerized sexually transmitted infection (STI) risk assessments, results in increased STI testing of adolescents at high risk for STI. Study design: In a 2-arm, randomized, controlled trial conducted at a single, urban, pediatric emergency department, adolescents completed a computerized sexual health survey. For patients assigned to the intervention arm, attending physicians received decision support to guide STI testing based on the sexual health survey-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. Results: Of the 728 enrolled patients, 635 (87.2%) had evaluable data (323 intervention arm; 312 usual care arm). STI testing frequency was higher in the intervention group compared with the usual care group (52.3% vs 42%; aOR 2 [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]). Conclusions: Providing sexual health survey-derived decision support to emergency department clinicians led to increased testing rates for STI 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 that could determine the generalizability of these findings and whether this process leads to increased STI detection. Trial registration: ClinicalTrials.gov: NCT02509572.

AB - Objectives: To assess whether clinical decision support, using computerized sexually transmitted infection (STI) risk assessments, results in increased STI testing of adolescents at high risk for STI. Study design: In a 2-arm, randomized, controlled trial conducted at a single, urban, pediatric emergency department, adolescents completed a computerized sexual health survey. For patients assigned to the intervention arm, attending physicians received decision support to guide STI testing based on the sexual health survey-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. Results: Of the 728 enrolled patients, 635 (87.2%) had evaluable data (323 intervention arm; 312 usual care arm). STI testing frequency was higher in the intervention group compared with the usual care group (52.3% vs 42%; aOR 2 [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]). Conclusions: Providing sexual health survey-derived decision support to emergency department clinicians led to increased testing rates for STI 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 that could determine the generalizability of these findings and whether this process leads to increased STI detection. Trial registration: ClinicalTrials.gov: NCT02509572.

KW - Adolescent

UR - http://www.scopus.com/inward/record.url?scp=85009232087&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85009232087&partnerID=8YFLogxK

U2 - 10.1016/j.jpeds.2016.12.045

DO - 10.1016/j.jpeds.2016.12.045

M3 - Article

C2 - 28081888

AN - SCOPUS:85009232087

JO - Journal of Pediatrics

JF - Journal of Pediatrics

SN - 0022-3476

ER -