BibTex format
@article{Wilson:2021:cid/ciaa1266,
author = {Wilson, J and Wallace, H and Loftus-Keeling, M and Ward, H and Davies, B and Vargas-Palacios, A and Hulme, C and Wilcox, M},
doi = {cid/ciaa1266},
journal = {Clinical Infectious Diseases},
pages = {e3172--e3180},
title = {Swab-yourself trial with economic monitoring and testing for infections collectively (SYSTEMATIC): Part 1. A diagnostic accuracy, and cost-effectiveness, study comparing clinician-taken versus self-taken rectal and pharyngeal samples for the diagnosis of gonorrhoea and chlamydia},
url = {http://dx.doi.org/10.1093/cid/ciaa1266},
volume = {73},
year = {2021}
}
RIS format (EndNote, RefMan)
TY - JOUR
AB - BackgroundUrogenital testing misses extragenital Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT). Extragenital self-sampling is frequently undertaken despite no robust RCT evidence of efficacy. We compared clinician-taken rectal and pharyngeal samples with self-taken samples for diagnostic accuracy and cost in MSM and females.MethodsProspective, convenience, sample in UK sexual health clinic. Randomised order of clinician and self-samples from pharynx and rectum, plus first catch urine (MSM) and vulvovaginal swabs (females), for NG/CT detection.ResultsOf 1793 participants (1284 females, 509 MSM), 116 had NG detected (75 urogenital site, 83 rectum, 72 pharynx); 9.4% infected females and 67.3% MSM were urogenital negative. 276 had CT detected (217 urogenital site, 249 rectum, 63 pharynx); 13.1% infected females and 71.8% MSM were urogenital negative. Sexual history did not identify those with rectal infections. Clinician-rectal and self-rectal positive percent agreements (PPA) for NG detection were 92.8% and 97.6%; clinician-rectal, and self-rectal PPA for CT detection were 95.6% and 97.2%. There was no difference in diagnostic accuracy between clinician and self-taken samples.Clinicians performed swabs quicker than participants so costs were lower. However, in asymptomatic people, non-qualified clinicians would oversee self-swabbing and these costs would be lower than clinician’s.ConclusionsThere was no difference in diagnostic accuracy of clinician compared with self-taken extragenital samples. Sexual history did not identify those with rectal infections so individuals should have extragenital clinician, or self-taken, samples. Clinician swabs cost less than self-swabs but in asymptomatic people, or doing home testing, their costs would be lower than clinician swabs.
AU - Wilson,J
AU - Wallace,H
AU - Loftus-Keeling,M
AU - Ward,H
AU - Davies,B
AU - Vargas-Palacios,A
AU - Hulme,C
AU - Wilcox,M
DO - cid/ciaa1266
EP - 3180
PY - 2021///
SN - 1058-4838
SP - 3172
TI - Swab-yourself trial with economic monitoring and testing for infections collectively (SYSTEMATIC): Part 1. A diagnostic accuracy, and cost-effectiveness, study comparing clinician-taken versus self-taken rectal and pharyngeal samples for the diagnosis of gonorrhoea and chlamydia
T2 - Clinical Infectious Diseases
UR - http://dx.doi.org/10.1093/cid/ciaa1266
UR - http://hdl.handle.net/10044/1/82121
VL - 73
ER -
