{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T17:51:42Z","timestamp":1793296302533,"version":"4.5.0"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2019,8,29]],"date-time":"2019-08-29T00:00:00Z","timestamp":1567036800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000030","name":"US Centers for Disease Control and Prevention","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100005258","name":"National Center for HIV\/AIDS, Viral Hepatitis, STD, and TB Prevention","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005258","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Tuberculosis Prevention Epidemiologic and Economic Modeling","award":["5NU38PS004644"],"award-info":[{"award-number":["5NU38PS004644"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,4,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Point-of-care testing (POCT) assays for chlamydia are being developed. Their potential impact on the burden of chlamydial infection in the United States, in light of suboptimal screening coverage, remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using a transmission model calibrated to data in the United States, we estimated the impact of POCT on chlamydia prevalence, incidence, and chlamydia-attributable pelvic inflammatory disease (PID) incidence, assuming status quo (Analysis 1) and improved (Analysis 2) screening frequencies. We tested the robustness of results to changes in POCT sensitivity, the proportion of patients getting treated immediately, the baseline proportion lost to follow-up (LTFU), and the average treatment delay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In Analysis 1, high POCT sensitivity was needed to reduce the chlamydia-associated burden. With a POCT sensitivity of 90%, reductions from the baseline burden only occurred in scenarios in which over 60% of the screened individuals would get immediate treatment and the baseline LTFU proportion was 20%. With a POCT sensitivity of 99% (baseline LTFU 10%, 2-week treatment delay), if everyone were treated immediately, the prevalence reduction was estimated at 5.7% (95% credible interval [CrI] 3.9\u20138.2%). If only 30% of tested persons would wait for results, the prevalence reduction was only 1.6% (95% CrI 1.1\u20132.3). POCT with 99% sensitivity could avert up to 12 700 (95% CrI 5000\u201322 200) PID cases per year, if 100% were treated immediately (baseline LTFU 20% and 3-week treatment delay). In Analysis 2, when POCT was coupled with increasing screening coverage, reductions in the chlamydia burden could be realized with a POCT sensitivity of 90%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>POCT could improve chlamydia prevention efforts if test performance characteristics are significantly improved over currently available options.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciz519","type":"journal-article","created":{"date-parts":[[2019,6,18]],"date-time":"2019-06-18T15:14:19Z","timestamp":1560870859000},"page":"1816-1823","source":"Crossref","is-referenced-by-count":28,"title":["Potential for Point-of-Care Tests to Reduce Chlamydia-associated Burden in the United States: A Mathematical Modeling Analysis"],"prefix":"10.1093","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9292-5670","authenticated-orcid":false,"given":"Minttu M","family":"R\u00f6nn","sequence":"first","affiliation":[{"name":"Prevention Policy Modeling Lab, Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas A","family":"Menzies","sequence":"first","affiliation":[{"name":"Prevention Policy Modeling Lab, Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas L","family":"Gift","sequence":"first","affiliation":[{"name":"Division of Sexually Transmitted Disease Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harrell W","family":"Chesson","sequence":"first","affiliation":[{"name":"Division of Sexually Transmitted Disease Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom A","family":"Trikalinos","sequence":"first","affiliation":[{"name":"Department of Health Services Policy & Practice, Brown University, Providence, Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meghan","family":"Bellerose","sequence":"first","affiliation":[{"name":"Prevention Policy Modeling Lab, Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yelena","family":"Malyuta","sequence":"first","affiliation":[{"name":"Prevention Policy Modeling Lab, Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9s","family":"Berruti","sequence":"first","affiliation":[{"name":"Division of Sexually Transmitted Disease Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte A","family":"Gaydos","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, John Hopkins University, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine K","family":"Hsu","sequence":"first","affiliation":[{"name":"Division of Sexually Transmitted Disease Prevention & Human Immunodeficiency Virus\/AIDS Surveillance, Massachusetts Department of Public Health, Boston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua A","family":"Salomon","sequence":"first","affiliation":[{"name":"Prevention Policy Modeling Lab, Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, Massachusetts"},{"name":"Center for Health Policy\/Center for Primary Care and Outcomes Research, Stanford University, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,8,29]]},"reference":[{"key":"2020041500553582400_CIT0001","volume-title":"Point-of-care diagnostic tests (POCTs) for sexually transmitted infections (STIs)","author":"World Health Organization","year":"2017"},{"key":"2020041500553582400_CIT0002","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1097\/00007435-199904000-00010","article-title":"The rapid test paradox: when fewer cases detected lead to more cases treated: a decision analysis of tests for Chlamydia trachomatis","volume":"26","author":"Gift","year":"1999","journal-title":"Sex Transm Dis"},{"key":"2020041500553582400_CIT0003","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1136\/sextrans-2013-051147","article-title":"An early evaluation of clinical and economic costs and benefits of implementing point of care NAAT tests for Chlamydia trachomatis and Neisseria gonorrhoea in genitourinary medicine clinics in England","volume":"90","author":"Turner","year":"2014","journal-title":"Sex Transm Infect"},{"key":"2020041500553582400_CIT0004","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1093\/cid\/ciy099","article-title":"Racial\/ethnic disparities in the lifetime risk of Chlamydia trachomatis diagnosis and adverse reproductive health outcomes among women in King County, Washington","volume":"67","author":"Chambers","year":"2018","journal-title":"Clin Infect Dis"},{"key":"2020041500553582400_CIT0005","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1586\/14787210.2014.880651","article-title":"Point of care diagnostics for sexually transmitted infections: perspectives and advances","volume":"12","author":"Gaydos","year":"2014","journal-title":"Expert Rev Anti Infect 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gonorrhoeae","volume":"142","author":"Cook","year":"2005","journal-title":"Ann Intern Med"},{"key":"2020041500553582400_CIT0009","volume-title":"The state of health care quality report","author":"The National Committee for Quality Assurance","year":"2015"},{"key":"2020041500553582400_CIT0010","doi-asserted-by":"crossref","first-page":"e1002483","DOI":"10.1371\/journal.pmed.1002483","article-title":"Pelvic inflammatory disease risk following negative results from chlamydia nucleic acid amplification tests (NAATs) versus non-NAATs in Denmark: a retrospective cohort","volume":"15","author":"Davies","year":"2018","journal-title":"PLOS Med"},{"key":"2020041500553582400_CIT0011","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1097\/00007435-199909000-00001","article-title":"Completeness of and duration of time before treatment after screening women for Chlamydia trachomatis infections","volume":"26","author":"Foglia","year":"1999","journal-title":"Sex Transm 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Intern Med"},{"key":"2020041500553582400_CIT0026","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1136\/sti.77.1.33","article-title":"Incidence of recurrent diagnoses of Chlamydia trachomatis genital infections among male and female soldiers of the US Army","volume":"77","author":"Barnett","year":"2001","journal-title":"Sex Transm Infect"},{"key":"2020041500553582400_CIT0027","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1097\/OLQ.0000000000000189","article-title":"Partner meeting place is significantly associated with gonorrhea and chlamydia in adolescents participating in a large high school sexually transmitted disease screening program","volume":"41","author":"Lewis","year":"2014","journal-title":"Sex Transm Dis"},{"key":"2020041500553582400_CIT0028","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1097\/OLQ.0000000000000798","article-title":"Chlamydia prevalence trends among women and men entering the National Job Training Program from 1990 through 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