title: Effectiveness of a risk screener in identifying hepatitis C virus in a primary care setting.
abstract: OBJECTIVE
  We evaluated an intervention designed to identify patients at risk for hepatitis C virus (HCV) through a risk screener used by primary care providers.
  
  
  METHODS
  A clinical reminder sticker prompted physicians at 3 urban clinics to screen patients for 12 risk factors and order HCV testing if any risks were present. Risk factor data were collected from the sticker; demographic and testing data were extracted from electronic medical records. We used the t test, χ(2) test, and rank-sum test to compare patients who had and had not been screened and developed an analytic model to identify the incremental value of each element of the screener.
  
  
  RESULTS
  Among screened patients, 27.8% (n = 902) were identified as having at least 1 risk factor. Of screened patients with risk factors, 55.4% (n = 500) were tested for HCV. Our analysis showed that 7 elements (injection drug use, intranasal drug use, elevated alanine aminotransferase, transfusions before 1992, ≥ 20 lifetime sex partners, maternal HCV, existing liver disease) accounted for all HCV infections identified.
  
  
  CONCLUSIONS
  A brief risk screener with a paper-based clinical reminder was effective in increasing HCV testing in a primary care setting.
authors.affiliation: Department of Health and Policy Management, Boston University School of Public Health, Boston, MA, USA. drainoni@bu.edu
authors.forename: Mari-Lynn
authors.initials: ML
authors.lastname: Drainoni
authors.forename: Alain H
authors.initials: AH
authors.lastname: Litwin
authors.forename: Bryce D
authors.initials: BD
authors.lastname: Smith
authors.forename: Elisa A
authors.initials: EA
authors.lastname: Koppelman
authors.forename: M Diane
authors.initials: MD
authors.lastname: McKee
authors.forename: Cindy L
authors.initials: CL
authors.lastname: Christiansen
authors.forename: Allen L
authors.initials: AL
authors.lastname: Gifford
authors.forename: Cindy M
authors.initials: CM
authors.lastname: Weinbaum
authors.forename: William N
authors.initials: WN
authors.lastname: Southern
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D005260:Female; D006526:Hepatitis C / Q000175:diagnosis*; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data; D007348:Insurance, Health / Q000706:statistics & numerical data; D008297:Male; D011320:Primary Health Care / Q000379:methods*; D044469:Racial Groups / Q000706:statistics & numerical data; D017010:Reminder Systems; D012307:Risk Factors
chemical_list: D000410:Alanine Transaminase