{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T12:33:27Z","timestamp":1791203607511,"version":"4.2.0"},"reference-count":18,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2014,7,3]]},"published-print":{"date-parts":[[2014,7]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>We aimed to explore patient pathways using a chlamydia\/gonorrhoea point-of-care (POC) nucleic acid amplification test (NAAT), and estimate and compare the costs of the proposed POC pathways with the current pathways using standard laboratory-based NAAT testing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design\/participants<\/jats:title><jats:p>Workshops were conducted with healthcare professionals at four sexual health clinics representing diverse models of care in the UK. They mapped out current pathways that used chlamydia\/gonorrhoea tests, and constructed new pathways using a POC NAAT. Healthcare professionals' time was assessed in each pathway.<\/jats:p><\/jats:sec><jats:sec><jats:title>Outcome measure<\/jats:title><jats:p>The proposed POC pathways were then priced using a model built in Microsoft Excel, and compared to previously published costs for pathways using standard NAAT-based testing in an off-site laboratory.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Pathways using a POC NAAT for asymptomatic and symptomatic patients and chlamydia\/gonorrhoea-only tests were shorter and less expensive than most of the current pathways. Notably, we estimate that POC testing as part of a sexual health screen for symptomatic patients, or as stand-alone chlamydia\/gonorrhoea testing, could reduce costs per patient by as much as \u00a316 or \u00a36, respectively. In both cases, healthcare professionals' time would be reduced by approximately 10\u2005min per patient.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>POC testing for chlamydia\/gonorrhoea in a clinical setting may reduce costs and clinician time, and may lead to more appropriate and quicker care for patients. Further study is warranted on how to best implement POC testing in clinics, and on the broader clinical and cost implications of this technology.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2014-005322","type":"journal-article","created":{"date-parts":[[2014,7,24]],"date-time":"2014-07-24T04:50:38Z","timestamp":1406177438000},"page":"e005322","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":39,"title":["Mapping patient pathways and estimating resource use for point of care versus standard testing and treatment of chlamydia and gonorrhoea in genitourinary medicine clinics in the UK"],"prefix":"10.1136","volume":"4","author":[{"given":"Elisabeth J","family":"Adams","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Ehrlich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine M E","family":"Turner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunj","family":"Shah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Macleod","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Goldenberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin K","family":"Meray","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikki","family":"Pearce","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Horner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2014,7,23]]},"reference":[{"key":"2024051512163112000_4.7.e005322.1","unstructured":"Public Health England. STI Data Tables. 2012. http:\/\/www.hpa.org.uk\/webc\/HPAwebFile\/HPAweb_C\/1247816547927"},{"key":"2024051512163112000_4.7.e005322.2","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2012-050834"},{"key":"2024051512163112000_4.7.e005322.3","unstructured":"CDC. Sexually transmitted diseases treatment guidelines 2010. 17 Dec 2010. Report No: 59 http:\/\/www.cdc.gov\/std\/treatment\/2010\/STD-Treatment-2010-RR5912.pdf"},{"key":"2024051512163112000_4.7.e005322.4","unstructured":"Medical Foundation for AIDS & Sexual Health & British Association for Sexual Health and HIV. Standards for the Management of Sexually Transmitted Infections (STI) 2010. 1 Jan 2010. http:\/\/www.bashh.org\/documents\/MF%20BASSH%20standards%2018Jan%20for%20the%20website.pdf"},{"key":"2024051512163112000_4.7.e005322.5","unstructured":"National Chlamydia Screening Programme. National Chlamydia Screening Programme Scorecard\u2014NCSP data based on data as of 25.05.12 for the period 1st April 2011\u201331st March 2012. GUM data are for the period of Jan\u2014December 2011. 2012. http:\/\/www.chlamydiascreening.nhs.uk\/ps\/resources\/data-tables\/NCSP_Scorecard_Q1-4_2011_12.pdf"},{"key":"2024051512163112000_4.7.e005322.6","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2013-051147"},{"key":"2024051512163112000_4.7.e005322.7","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1136\/sextrans-2012-050656","article-title":"Point-of-care tests for the diagnosis of Neisseria gonorrhoeae infection: a systematic review of operational and performance characteristics","volume":"89","author":"Watchirs Smith","year":"2012","journal-title":"Sex Transm Infect"},{"key":"2024051512163112000_4.7.e005322.8","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0014144"},{"key":"2024051512163112000_4.7.e005322.9","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39402.463854.AE"},{"key":"2024051512163112000_4.7.e005322.10","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.03461-12"},{"key":"2024051512163112000_4.7.e005322.11","unstructured":"Pathway Analytics. Sexual Health Tariff. http:\/\/www.pathwayanalytics.com\/sexual-health\/about-the-tariff (last accessed 26 Jun 2014)."},{"key":"2024051512163112000_4.7.e005322.12","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(93)92299-9"},{"key":"2024051512163112000_4.7.e005322.13","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)02699-4"},{"key":"2024051512163112000_4.7.e005322.14","unstructured":"Centers for Disease Control and Prevention (CDC). Antibiotic stewardship\u2014the ultimate return on investment. 5 Nov 2013. http:\/\/www.cdc.gov\/getsmart\/healthcare\/learn-from-others\/factsheets\/antibiotic-use.html"},{"key":"2024051512163112000_4.7.e005322.15","unstructured":"Department of Health. Antimicrobial stewardship: \u2018Smart Smart\u2014then focus\u2019. 18 Nov 2011. https:\/\/www.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/215308\/dh_131181.pdf"},{"key":"2024051512163112000_4.7.e005322.16","first-page":"551","article-title":"UK national guideline for the management of gonorrhoea in adults, 2011","volume":"22","author":"Bignell","year":"2011","journal-title":"Int J STI AIDS"},{"key":"2024051512163112000_4.7.e005322.17","unstructured":"Horner PJ Boag FC . 2006 UK national guideline for the management of genital tract infection with Chlamydia trachomatis . British Association of Sexual Health & HIV, 2006."},{"key":"2024051512163112000_4.7.e005322.18","doi-asserted-by":"publisher","DOI":"10.1097\/QCO.0b013e32834e9a6a"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2014-005322","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,15]],"date-time":"2024-05-15T19:29:27Z","timestamp":1715801367000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2014-005322"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,7]]},"references-count":18,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2014,7,23]]},"published-print":{"date-parts":[[2014,7]]}},"alternative-id":["10.1136\/bmjopen-2014-005322"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2014-005322","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,7]]}}}