{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T04:54:25Z","timestamp":1781067265670,"version":"3.54.1"},"reference-count":38,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,4,22]],"date-time":"2022-04-22T00:00:00Z","timestamp":1650585600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["KL2 TR002346"],"award-info":[{"award-number":["KL2 TR002346"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Sexually transmitted infections (STIs), including chlamydia, gonorrhea, and human immunodeficiency virus (HIV) pose a significant health burden in adolescents. Many adolescents receiving care in the emergency department (ED) are in need of testing, regardless of their chief complaint. Our objective was to determine whether an electronic, risk\u2010based STI screening program in our ED was associated with an increase in STI testing among at\u2010risk adolescents.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective cohort analysis of patient outcomes in our pediatric ED after integrating an Audio\u2010enhanced Computer\u2010Assisted Self\u2010Interview (ACASI) as standard of care. It obtained a focused sexual history and generated STI testing recommendations. Patient answers and testing recommendations were integrated in real\u2010time into the electronic health record. Patients who tested positive received treatment according to our standard\u2010of\u2010care practices.<\/jats:p><jats:p>All patients 15\u201321 years of age were asked to complete this on an opt\u2010out basis, regardless of the reason for their ED visit. Exclusions included those unable to independently use a tablet, severe illness, sexual assault, or non\u2010English speaking. Our primary outcome was to describe STI\u2010testing recommendations and test results among ACASI participants. We also compared STI testing between ACASI participants and those who were eligible but did not use it.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the first 13 months, 28.9% (1788\/6194) of eligible adolescents completed the ACASI and 44.2% (321\/790) accepted recommended STI testing. The mean age of participants was 16.6\u00a0\u00b1\u00a01.3 years, with 65.4% (1169) being female.<\/jats:p><jats:p>Gonorrhea\/chlamydia testing was significantly higher among participants vs. non\u2010participants (20.1% [359\/1788] vs 4.8% [212\/4406]; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.0001). The proportion of positive STI tests was similar between the two groups: 24.8% (89\/359) vs. 24.5% (52\/212; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.94) were positive for chlamydia and\/or gonorrhea, while 0.6% (2\/354) participants vs. 0% non\u2010participants (<jats:italic>p<\/jats:italic>\u00a0&gt;\u00a00.99) were positive for HIV. Among participants whose chief complaints were unlikely to be related to STIs but accepted recommended testing, 20.9% (37\/177) were positive for gonorrhea or chlamydia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our program facilitated STI testing in the ED and identified many adolescents with STIs, even when their ED complaint was for unrelated reasons. More rigorous implementation is needed to determine the impact of deployment of ACASI to all eligible adolescents and addressing barriers to accepting STI testing recommendations.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.14465","type":"journal-article","created":{"date-parts":[[2022,2,20]],"date-time":"2022-02-20T12:33:02Z","timestamp":1645360382000},"page":"879-889","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Impact of risk\u2010based sexually transmitted infection screening in\u00a0the emergency department"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5919-6835","authenticated-orcid":false,"given":"Fahd A.","family":"Ahmad","sequence":"first","affiliation":[{"name":"Department of Pediatrics Washington University School of Medicine in St. Louis  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7394-3048","authenticated-orcid":false,"given":"Kayleigh","family":"Fischer","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Children's Memorial Hermann Hospital University of Texas Health Science Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongjie","family":"Gu","sequence":"additional","affiliation":[{"name":"Division of Biostatistics Washington University School of Medicine in St. Louis  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas\u00a0C.","family":"Bailey","sequence":"additional","affiliation":[{"name":"Department of Medicine Washington University School of Medicine in St. Louis  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7642-3777","authenticated-orcid":false,"given":"Donna B.","family":"Jeffe","sequence":"additional","affiliation":[{"name":"Department of Medicine Washington University School of Medicine in St. Louis  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2603-7157","authenticated-orcid":false,"given":"Christopher R.","family":"Carpenter","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Washington University School of Medicine in St. Louis  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip R. O.","family":"Payne","sequence":"additional","affiliation":[{"name":"Institute for Informatics Washington University School of Medicine in St. Louis  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,4,22]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2004-815595"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.rr6805a1"},{"key":"e_1_2_10_4_1","unstructured":"Centers for Disease Control and Prevention.Sexually transmitted disease surveillance 2018. Department of Health and Human Services.https:\/\/www.cdc.gov\/std\/stats18\/default.htm"},{"key":"e_1_2_10_5_1","unstructured":"Centers for Disease Control and Prevention.Youth risk behavior surveillance\u2014United States 2017. 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