title: Variation in partner notification outcomes for chlamydia in UK genitourinary medicine clinics: multilevel study.
abstract: OBJECTIVE
  To compare different ways of measuring partner notification (PN) outcomes with published audit standards, examine variability between clinics and examine factors contributing to variation in PN outcomes in genitourinary medicine (GUM) clinics in the UK.
  
  
  METHODS
  Reanalysis of the 2007 BASHH national chlamydia audit. The primary outcome was the number of partners per index case tested for chlamydia, as verified by a healthcare worker or, if missing, reported by the patient. Control charts were used to examine variation between clinics considering missing values as zero or excluding missing values. Hierarchical logistic regression was used to investigate factors contributing to variation in outcomes.
  
  
  RESULTS
  Data from 4616 individuals in 169 genitourinary medicine clinics were analysed. There was no information about the primary outcome in 41% of records. The mean number of partners tested for chlamydia ranged from 0 to 1.5 per index case per clinic. The median across all clinics was 0.47 when missing values were assumed to be zero and 0.92 per index case when missing values were excluded. Men who have sex with men were less likely than heterosexual men and patients with symptoms (4-week look-back period) were less likely than asymptomatic patients (6-month look-back) to report having one or more partners tested for chlamydia. There was no association between the primary outcome and the type of the health professional giving the PN advice.
  
  
  CONCLUSIONS
  The completeness of PN outcomes recorded in clinical notes needs to improve. Further research is needed to identify auditable measures that are associated with successful PN that prevents repeated chlamydia in index cases.
authors.affiliation: Division of Clinical Epidemiology & Biostatistics, Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, Bern 3012, Switzerland.
authors.forename: Sereina A
authors.initials: SA
authors.lastname: Herzog
authors.forename: Hugo
authors.initials: H
authors.lastname: McClean
authors.forename: Chris A
authors.initials: CA
authors.lastname: Carne
authors.forename: Nicola
authors.initials: N
authors.lastname: Low
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data; D002690:Chlamydia Infections / Q000453:epidemiology*; D016358:Contact Tracing; D005260:Female; D006801:Humans; D008297:Male; D008485:Medical Audit; D008499:Medical Records / Q000592:standards; D008875:Middle Aged; D015588:Observer Variation; D011379:Prognosis; D012725:Sexual Behavior / Q000706:statistics & numerical data; D012747:Sexual Partners; D006113:United Kingdom / Q000453:epidemiology; D014686:Venereology / Q000706:statistics & numerical data; D055815:Young Adult