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Cantor A, Dana T, Griffin JC, et al. Screening for Chlamydial and Gonococcal Infections: A Systematic Review Update for the U.S. Preventive Services Task Force [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2021 Sep. (Evidence Synthesis, No. 206.)
Screening for Chlamydial and Gonococcal Infections: A Systematic Review Update for the U.S. Preventive Services Task Force [Internet].
Show detailsTable 3Studies Evaluating Strategies for Identifying Persons Who Are at Increased Risk for Chlamydial or Gonococcal Infections
| Author, year | Strategy | Infection | Sex | Study design | Population, N | Results | Quality rating |
|---|---|---|---|---|---|---|---|
| Falasinnu et al., 201462 | Risk estimation model | GC, CT | M, F | Cross-sectional | Asymptomatic men and women, attending clinic for STI testing; Canada (n=25,393) |
Derivation population (n=10,437): AUC=0.75; 95% CI, 0.72 to 0.80 Validation population (n=14,956): AUC=0.64; 95% CI, 0.61 to 0.67 | Fair |
| Falasinnu et al., 201663 | Risk estimation model | GC, CT | M, F | Cross-sectional | Asymptomatic men and women, attending clinic for STI testing; Canada (n=20,862) |
Derivation population (n=10,437):AUC= 0.74 (95% CI 0.70 to 0.77) Validation population (n=10,425): AUC=0.69 (95% CI 0.67 to 0.71) | Fair |
| Falasinnu et al., 201664 | Population guideline vs. guideline + number of risk factors vs. clinical risk scorea | STI | M, F | Cross-sectional | Asymptomatic men and women, attending clinic for STI testing; Canada (n=35,818) |
Guideline (any vs. no risk factors): AUC 0.55 (95% CI 0.54 to 0.56) Guideline (numbers of risk factors): AUC 0.64 (95% CI 0.63 to 0.66) Risk score model: AUC 0.73 (95% CI 0.71 to 0.74) | Fair |
| Grentzer et al., 201566 | Age vs. age + partner vs. risk-based screeningb | GC, CT | F | Cross-sectional | Women age 14 to 45 years attending clinic for IUD insertion; U.S. (n=5087) |
Sensitivity; specificity; NPV; PPV; % Age: 80.7; 48.1; 98.8; 4.5 Age + partner: 84.7; 44.8; 99.0; 4.5 Risk: 99.3; 7.6; 99.7; 3.2 | Fair |
| Javanbakht et al., 201868 | Risk estimation | GC | M, F | Case-Control | Men and women age 15 to 29 years reporting giving oral sex to partner of opposite sex in past 90 days; U.S. (n=245) |
Risk of pharyngeal gonorrhea: Number of oral sex partners in 3 months: aOR 5.7; 95% CI 1.3 to 25.6 aOR 5.7; 95% CI 1.3 to 25.6 Presence of concurrent urogenital gonorrhea: aOR 6.2; 95% CI 2.6-14.3 | Fair |
| Lavoue et al., 201469 | Model to predict infectionc | CT | F | Cross-sectional | Women with surgical abortion and CT test; France (n=652 derivation, n=326 validation) |
Sensitivity, %; specificity, % Cutoff 40: 100; 26.9 Cutoff 60: 83.3; 58.8 | Fair |
| Miller, et al., 200070 | Compares 9 sets of screening criteriad | CT | F | Cross-sectional | Women in family planning clinics; U.S. (n=4754) |
Criteria; AUC (SD); sensitivity, %; specificity, % CDC: NA, 85, 38 Seattle-1: 0.599 (0.017); 56; 54 Wisconsin: 0.604 (0.023); 50; 66 Ontario: 0.630 (0.017); 76; 41 California-1: 0.633 (0.016); 94; 20 Age ≤ 22: 0.687 (0.014); 77; 51 California-2: 0.701 (0.015); 97; 9 Seattle-3: 0.723 (0.015); 92; 31 Seattle-2: 0.726 (0.014); 84; 51 | Fair |
Abbreviations: aOR = adjusted odds ratio; AUC = area under the receiver operating characteristic curve; CDC = Centers for Disease Control and Prevention; CI = confidence interval; CT = chlamydia; F = female; GC = gonorrhea; IUD = intrauterine device; M = male; NA = not applicable; NPV = negative predictive value; OR = odds ratio; PID = pelvic inflammatory disease; PPV = positive predictive value; RCT = randomized controlled trial; RR = relative risk; SD = standard deviation; STD = sexually transmitted disease; STI = sexually transmitted infection; U.K. = United Kingdom; U.S. = United States.
- a
Population guideline from the Public Health Agency of Canada (any vs. no risk factors including age <30, 2 or more sexual partners, injection drug use, sexual contact with injection drug user, sexual contact with commercial sex workers, previous STD); guideline (numbers of risk factors including age <30, 2 or more sexual partners, injection drug use, sexual contact with injection drug user, sexual contact with commercial sex workers, previous STD); clinical risk score model (age, race/ethnicity [white/nonwhite], number of sexual partners [0, 1-2, 3 or more], previous CT or GC diagnosis [yes/no], condom use [always, not always]; injection drug use [yes/no]).
- b
Age-based (≤25 years); age + partner-based (≤25 years + multiple partners); risk-based (≤25 years, multiple partners, history of STI, inconsistent condom use).
- c
Model includes: 0 or 1 child (43 points); not using contraception (34 points); gestational age of abortion >10 weeks (23 points). Low-risk of CT infection = 0-40 points; intermediate-risk = 40-60; high-risk = 60-100.
- d
Screening criteria listed in publication (Miller, 200069).
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