title: Use of computerized medical records to determine the feasibility of testing for chlamydia without patients seeing a practitioner.
abstract: The proportion of clinically important diagnoses in a low-risk, asymptomatic population who use a computer-assisted self-interview (CASI) to assess risk was needed to determine optimal health service delivery. Medical records were retrospectively analysed between July 2008 and June 2009 for risk characteristics and diagnoses. A total of 7733 new patients completed a CASI, of whom 1060 were asymptomatic heterosexuals. From this low-risk group, 26 diagnoses were made on the day of presentation, including 22 cases of genital warts (2.08% [95% confidence interval (CI) 1.22-2.93]), three cases of genital herpes (0.28% [95% CI 0.055-0.82]) and one case of unintended pregnancy (0.094% [95% CI 0.0061-0.52]). Additionally, there were 54 cases of chlamydia detected (5.09% [95% CI 3.77-6.42]). As chlamydia is effectively diagnosed and managed from self-collected samples, patient review is not always required. This study provides evidence for an express testing service for chlamydia to streamline the screening of low-risk, asymptomatic heterosexual patients as identified by CASI without the need to for a traditional face-to-face consultation.
authors.affiliation: Sexual Health Unit, School of Population Health, The University of Melbourne, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Yeung
authors.forename: M
authors.initials: M
authors.lastname: Bush
authors.forename: R
authors.initials: R
authors.lastname: Cummings
authors.forename: C S
authors.initials: CS
authors.lastname: Bradshaw
authors.forename: M
authors.initials: M
authors.lastname: Chen
authors.forename: H
authors.initials: H
authors.lastname: Williams
authors.forename: I
authors.initials: I
authors.lastname: Denham
authors.forename: C K
authors.initials: CK
authors.lastname: Fairley
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia / Q000453:epidemiology; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008403:Mass Screening / Q000379:methods; D016347:Medical Records Systems, Computerized; D012017:Referral and Consultation; D012189:Retrospective Studies; D012307:Risk Factors; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000175:diagnosis* / Q000453:epidemiology; D011795:Surveys and Questionnaires