title: Effectiveness of a risk-based visitor-prioritizing system at a sexually transmitted infection outpatient clinic.
abstract: OBJECTIVE
  The objective of this study was to study the efficacy/effectiveness of a risk-based visitor-prioritizing system at a sexually transmitted infection (STI) clinic aimed to improve screening capacity by providing tailored service.
  
  
  METHODS
  In April 2004, a prioritizing system was implemented that classifies visitors as high or low risk depending on reported sexual behavior and previous STI events. The high- and low-risk groups are assigned to standard and short screening protocols, respectively. Both protocols include diagnostic testing for syphilis, urogenital gonorrhea, chlamydia, and optional for HIV. To assess the effectiveness of the system, differences in prevalence of STI diagnoses in the standard and short protocol were analyzed by chi test.
  
  
  RESULTS
  In total, 14,391 visitors (64%) received standard screening and 8,056 visitors (36%) received short screening. The STI prevalence in both groups was 18.1% and 7.6%, respectively (P <0.001); prevalence of HIV was 1.8% and 0.3%, respectively (P <0.001). The sensitivity of the prioritizing system was 74%. Specificity was substantially lower (42%).
  
  
  CONCLUSIONS
  This prioritizing system is effective in differentiating between visitors at high and low risk for STI, contributing to provision of tailored STI service, increasing efficiency, and client access to STI service.
authors.affiliation: Cluster of Infectious Diseases, STI Outpatient Clinic, Health Service of Amsterdam, Amsterdam, The Netherlands. theijman@ggd.amsterdam.nl
authors.forename: Titia L J
authors.initials: TL
authors.lastname: Heijman
authors.forename: Akke K
authors.initials: AK
authors.lastname: Van der Bij
authors.forename: Henry J C
authors.initials: HJ
authors.lastname: De Vries
authors.forename: Edwin J M
authors.initials: EJ
authors.lastname: Van Leent
authors.forename: Harold F J
authors.initials: HF
authors.lastname: Thiesbrummel
authors.forename: Han S A
authors.initials: HS
authors.lastname: Fennema
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D009426:Netherlands / Q000453:epidemiology; D017063:Outcome Assessment, Health Care; D015995:Prevalence; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012749:Sexually Transmitted Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D014218:Triage; D014850:Waiting Lists