Molecular chlamydia and gonorrhoea point of care tests implemented into routine practice: Systematic review and value proposition development

<h4>Background</h4> Sexually Transmitted Infections, including Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT), continue to be a global health problem. Increased access to point-of-care-tests (POCTs) could help detect infection and lead to appropriate management of cases and co...

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Autores principales:	Sebastian S. Fuller, Eleanor Clarke, Emma M. Harding-Esch
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/9c00076700db4afba4cf700d1c35bf58
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spelling	oai:doaj.org-article:9c00076700db4afba4cf700d1c35bf582021-11-18T06:22:37ZMolecular chlamydia and gonorrhoea point of care tests implemented into routine practice: Systematic review and value proposition development1932-6203https://doaj.org/article/9c00076700db4afba4cf700d1c35bf582021-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8575247/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4> Sexually Transmitted Infections, including Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT), continue to be a global health problem. Increased access to point-of-care-tests (POCTs) could help detect infection and lead to appropriate management of cases and contacts, reducing transmission and development of reproductive health sequelae. Yet diagnostics with good clinical effectiveness evidence can fail to be implemented into routine care. Here we assess values beyond clinical effectiveness for molecular CT/NG POCTs implemented across diverse routine practice settings. <h4>Methods</h4> We conducted a systematic review of peer-reviewed primary research and conference abstract publications in Medline and Embase reporting on molecular CT/NG POCT implementation in routine clinical practice until 16th February 2021. Results were extracted into EndNote software and initially screened by title and abstract by one author according to the inclusion and exclusion criteria. Articles that met the criteria, or were unclear, were included for full-text assessment by all authors. Results were synthesised to assess the tests against guidance criteria and develop a CT/NG POCT value proposition for multiple stakeholders and settings. <h4>Findings</h4> The systematic review search returned 440 articles; 28 were included overall. The Cepheid CT/NG GeneXpert was the only molecular CT/NG POCT implemented and evaluated in routine practice. It did not fulfil all test guidance criteria, however, studies of test implementation showed multiple values for test use across various healthcare settings and locations. Our value proposition highlights that the majority of values are setting-specific. Sexual health services and outreach services have the least overlap, with General Practice and other non-sexual health specialist services serving as a “bridge” between the two. <h4>Conclusions</h4> Those wishing to improve CT/NG diagnosis should be supported to identify the values most relevant to their settings and context, and prioritise implementation of tests that are most closely aligned with those values.Sebastian S. FullerEleanor ClarkeEmma M. Harding-EschPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Sebastian S. Fuller Eleanor Clarke Emma M. Harding-Esch Molecular chlamydia and gonorrhoea point of care tests implemented into routine practice: Systematic review and value proposition development
description	<h4>Background</h4> Sexually Transmitted Infections, including Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT), continue to be a global health problem. Increased access to point-of-care-tests (POCTs) could help detect infection and lead to appropriate management of cases and contacts, reducing transmission and development of reproductive health sequelae. Yet diagnostics with good clinical effectiveness evidence can fail to be implemented into routine care. Here we assess values beyond clinical effectiveness for molecular CT/NG POCTs implemented across diverse routine practice settings. <h4>Methods</h4> We conducted a systematic review of peer-reviewed primary research and conference abstract publications in Medline and Embase reporting on molecular CT/NG POCT implementation in routine clinical practice until 16th February 2021. Results were extracted into EndNote software and initially screened by title and abstract by one author according to the inclusion and exclusion criteria. Articles that met the criteria, or were unclear, were included for full-text assessment by all authors. Results were synthesised to assess the tests against guidance criteria and develop a CT/NG POCT value proposition for multiple stakeholders and settings. <h4>Findings</h4> The systematic review search returned 440 articles; 28 were included overall. The Cepheid CT/NG GeneXpert was the only molecular CT/NG POCT implemented and evaluated in routine practice. It did not fulfil all test guidance criteria, however, studies of test implementation showed multiple values for test use across various healthcare settings and locations. Our value proposition highlights that the majority of values are setting-specific. Sexual health services and outreach services have the least overlap, with General Practice and other non-sexual health specialist services serving as a “bridge” between the two. <h4>Conclusions</h4> Those wishing to improve CT/NG diagnosis should be supported to identify the values most relevant to their settings and context, and prioritise implementation of tests that are most closely aligned with those values.
format	article
author	Sebastian S. Fuller Eleanor Clarke Emma M. Harding-Esch
author_facet	Sebastian S. Fuller Eleanor Clarke Emma M. Harding-Esch
author_sort	Sebastian S. Fuller
title	Molecular chlamydia and gonorrhoea point of care tests implemented into routine practice: Systematic review and value proposition development
title_short	Molecular chlamydia and gonorrhoea point of care tests implemented into routine practice: Systematic review and value proposition development
title_full	Molecular chlamydia and gonorrhoea point of care tests implemented into routine practice: Systematic review and value proposition development
title_fullStr	Molecular chlamydia and gonorrhoea point of care tests implemented into routine practice: Systematic review and value proposition development
title_full_unstemmed	Molecular chlamydia and gonorrhoea point of care tests implemented into routine practice: Systematic review and value proposition development
title_sort	molecular chlamydia and gonorrhoea point of care tests implemented into routine practice: systematic review and value proposition development
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/9c00076700db4afba4cf700d1c35bf58
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Molecular chlamydia and gonorrhoea point of care tests implemented into routine practice: Systematic review and value proposition development

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