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Bacterial Sexually Transmitted Disease Screening Outside the Clinic—Implications for the Modern Sexually Transmitted Disease Program
BACKGROUNDThe development of noninvasive nucleic acid amplification tests for chlamydia and gonorrhea has facilitated innovation in moving sexually transmitted disease (STD) screening to nonclinical settings. However, limited data are available to inform local STD programs on evidence-based approaches to STD screening in nonclinical settings in the United States.
METHODSWe conducted a systematic review of the literature published since 2000 related to chlamydia, gonorrhea, and syphilis screening in US correctional settings, bathhouses and sex venues, self-collected at-home testing, and other nonclinical sites.
RESULTSSixty-four articles met eligibility criteria and were reviewed. Although data on testing volume and positivity were available, there were scarce data on the proportion of new positives treated and the programmatic costs for the various screening programs. Screening in correctional settings identified a sizable amount of asymptomatic infections. The value and sustainability of screening in the other nonclinical settings examined was not clear from the published literature.
CONCLUSIONSLocal and state health departments should explore the development of sustainable jail and juvenile detention screening programs for STDs. Furthermore, local programs should pilot outreach and home-based STD screening programs to determine if they are identifying asymptomatic persons who would not have otherwise been found. Local programs are encouraged to present and publish their findings related to non–clinic-based screening to enhance the limited body of literature; data on the proportion of new infections treated and the local program costs are needed.
Journal Article
Systematic reviews – do they ‘work’ in informing decision-making around health inequalities?
The question of 'what works' is a fundamental one not only for politicians and policy makers who need to devise or implement policies on everything from reducing juvenile crime to increasing the national wealth, but it is also fundamental for citizens on the receiving end of interventions. Whilst research can help in informing decisions about what works, conflicting research findings, and simple information overload often simply cloud the issue. In clinical decision making, such uncertainty about the true effects of interventions acted as an important stimulus to the adoption of systematic reviews as a way of marshalling robust scientific evidence and bringing it to bear on clinical decisions. While this approach, led by the Cochrane Collaboration, met with early criticism, particularly on the grounds of 'cookbook medicine', broad acceptance of the general principles of systematic reviews meant that they were quickly and widely adopted to synthesize evidence on the effects of health technologies, and their extension to policies and practices informed by disciplines other than medicine quickly followed.
Journal Article
Health and medicine : the impact of science and technology
Examines advances in surgery that use robots and computers, developments in the prevention and treatment of disease, stem cell, genetic screening, and genetic engineering, imaging techniques that let us see inside the body, and challenges for the future, including health care for aging populations.
Book
Nanotechnology and medicine
This book discusses how nanotechnology is used in delivering medications, enhancing imaging, helping rebuild damaged tissues and more.
Book