Screening for gonorrhea and chlamydia : systematic review to update the U.S. Preventive Services Task Force recommendations

DATA EXTRACTION: One investigator extracted data on participants, study design, analysis, followup, and results and a second investigator confirmed key data. Investigators independently dual-rated study quality and applicability using established criteria. DATA SYNTHESIS: Screening a subset of asymp...

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Main Authors: Nelson, Heidi D., Zakher, Bernadette (Author), Cantor, Amy (Author), Deagas, Monica (Author)
Corporate Authors: United States Agency for Healthcare Research and Quality, Oregon Health & Science University Pacific Northwest Evidence-based Practice Center, U.S. Preventive Services Task Force
Format: eBook
Language:English
Published: Rockville, MD Agency for Healthcare Research and Quality September 2014, 2014
Series:Evidence syntheses
Subjects:
Online Access:
Collection: National Center for Biotechnology Information - Collection details see MPG.ReNa
Summary:DATA EXTRACTION: One investigator extracted data on participants, study design, analysis, followup, and results and a second investigator confirmed key data. Investigators independently dual-rated study quality and applicability using established criteria. DATA SYNTHESIS: Screening a subset of asymptomatic young women for chlamydia in a good-quality trial did not statistically significantly reduce pelvic inflammatory disease over the following year (relative risk, 0.39 [95% CI, 0.14 to 1.08]), while one previous trial reported a reduction. An observational study evaluating a risk prediction tool to identify persons with chlamydia in high-risk populations had low predictive ability and applicability. In 10 new studies of asymptomatic participants, nucleic acid amplification tests demonstrated sensitivity of 86% or greater and specificity of 97% or greater for diagnosing gonorrhea and chlamydia, regardless of specimen type or test.
BACKGROUND: Previous research has supported screening for gonorrhea and chlamydia in asymptomatic sexually active women, including pregnant women, who are younger than age 25 years or at increased risk, but not other patient populations. PURPOSE: To update the 2005 and 2007 systematic reviews for the U.S. Preventive Services Task Force on screening for gonorrhea and chlamydia in men and women, including pregnant women and adolescents. DATA SOURCES: MEDLINE (2004 to June 13, 2014), Cochrane Central Register of Controlled Trials (through May 2014), Cochrane Database of Systematic Reviews (through May 2014), Health Technology Assessment Database (through May 2014), Database of Abstracts of Reviews of Effects (through May 2014), and reference lists. STUDY SELECTION: English-language trials and observational studies about screening effectiveness, test accuracy, and screening harms.
LIMITATIONS: Studies of screening benefits and harms were lacking for men, pregnant women, adolescents, and subgroups. Only screening tests and methods cleared by the U.S. Food and Drug Administration for current clinical practice were included to determine diagnostic accuracy, excluding rectal, pharyngeal, and self-administered specimens obtained outside a clinical setting. CONCLUSIONS: Chlamydia screening in young women may reduce pelvic inflammatory disease. Nucleic acid amplification tests are accurate for diagnosing gonorrhea and chlamydia in asymptomatic persons using various types of specimens. Research is needed on the effectiveness of screening to reduce adverse health outcomes in specific population groups, effectiveness of different screening strategies, and adverse effects of screening to further inform practice guidelines
Item Description:Title from PDF title page. - "Contract No. HHS-290-2007-10057-I, Task Order No. 13."
Physical Description:1 PDF file (v, 118 pages) illustrations