{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T12:33:32Z","timestamp":1791203612655,"version":"4.2.0"},"reference-count":29,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2013,10,27]]},"published-print":{"date-parts":[[2014,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To estimate the costs and benefits of clinical pathways incorporating a point of care (POC) nucleic acid amplification test (NAAT) for chlamydia and gonorrhoea in genitourinary medicine (GUM) clinics compared with standard off-site laboratory testing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>We simulated 1.2 million GUM clinic attendees in England. A simulation in Microsoft Excel was developed to compare existing standard pathways of management for chlamydia and gonorrhoea with a POC NAAT. We conducted scenario analyses to evaluate the robustness of the model findings. The primary outcome was the incremental cost-effectiveness ratio. Secondary outcomes included the number of inappropriate treatments, complications and transmissions averted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The baseline cost of using the point of POC NAAT was \u00a3103.9 million compared with \u00a3115.6 million for standard care. The POC NAAT was also associated with a small increase of 46 quality adjusted life years, making the new test both more effective and cheaper. Over 95\u2005000 inappropriate treatments might be avoided by using a POC NAAT. Patients receive diagnosis and treatment on the same day as testing, which may also prevent 189 cases of pelvic inflammatory disease and 17\u2005561 onward transmissions annually.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Replacing standard laboratory tests for chlamydia and gonorrhoea with a POC test could be cost saving and patients would benefit from more accurate diagnosis and less unnecessary treatment. Overtreatment currently accounts for about a tenth of the reported treatments for chlamydia and gonorrhoea and POC NAATs would effectively eliminate the need for presumptive treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/sextrans-2013-051147","type":"journal-article","created":{"date-parts":[[2013,11,23]],"date-time":"2013-11-23T02:20:40Z","timestamp":1385173240000},"page":"104-111","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":75,"title":["An early evaluation of clinical and economic costs and benefits of implementing point of care NAAT tests for\n                    <i>Chlamydia trachomatis<\/i>\n                    and\n                    <i>Neisseria gonorrhoea<\/i>\n                    in genitourinary medicine clinics in England"],"prefix":"10.1136","volume":"90","author":[{"given":"Katherine M E","family":"Turner","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeff","family":"Round","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Horner","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":"Arminder","family":"Deol","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth J","family":"Adams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2013,11,22]]},"reference":[{"key":"2024051410192906000_90.2.104.1","unstructured":"Health Protection Agency. 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BASHH National Audit Group. H McClean. http:\/\/www.bashh.org\/documents\/3786.xls"},{"key":"2024051410192906000_90.2.104.8","unstructured":"NCSP quality assurance 2010 Turnaround times audit 2010. http:\/\/www.chlamydiascreening.nhs.uk\/ps\/resources\/quality\/Nov_2010_QA_repor_turnaround_times_Final_V1.1.pdf"},{"key":"2024051410192906000_90.2.104.9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3310\/hta14290","article-title":"Systematic review of the clinical effectiveness and cost-effectiveness of rapid point-of-care tests for the detection of genital chlamydia infection in women and men","volume":"14","author":"Hislop","year":"2010","journal-title":"Health Technol Assess"},{"key":"2024051410192906000_90.2.104.10","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":"2024051410192906000_90.2.104.11","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39402.463854.AE"},{"key":"2024051410192906000_90.2.104.12","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.03461-12"},{"key":"2024051410192906000_90.2.104.13","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01930-12"},{"key":"2024051410192906000_90.2.104.14","doi-asserted-by":"publisher","DOI":"10.1136\/sti.79.5.363"},{"key":"2024051410192906000_90.2.104.15","doi-asserted-by":"publisher","DOI":"10.1097\/00007435-199904000-00010"},{"key":"2024051410192906000_90.2.104.16","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-11-30"},{"key":"2024051410192906000_90.2.104.17","doi-asserted-by":"publisher","DOI":"10.1098\/rsif.2011.0131"},{"key":"2024051410192906000_90.2.104.18","doi-asserted-by":"publisher","DOI":"10.1098\/rstb.1999.0431"},{"key":"2024051410192906000_90.2.104.19","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kws583"},{"key":"2024051410192906000_90.2.104.20","unstructured":"Adams EJ Ehrlich A Turner KME . Patient care pathways using chlamydia and gonorrhoea tests are evolving: point of care nucleic acid amplification tests may reduce genitourinary medicine service delivery costs. Submitted."},{"key":"2024051410192906000_90.2.104.21","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2010.048694"},{"key":"2024051410192906000_90.2.104.22","unstructured":"Institute of Medicine. Vaccines for the 21st Century: A tool for decision making. Washington, DC: National Academy Press, 2000."},{"key":"2024051410192906000_90.2.104.23","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0b013e31815b07dd"},{"key":"2024051410192906000_90.2.104.24","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-6-106"},{"key":"2024051410192906000_90.2.104.25","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2006.024364"},{"key":"2024051410192906000_90.2.104.26","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0b013e318151497d"},{"key":"2024051410192906000_90.2.104.27","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2011-050355"},{"key":"2024051410192906000_90.2.104.28","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0019263"},{"key":"2024051410192906000_90.2.104.29","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2012-050834"}],"container-title":["Sexually Transmitted Infections"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/sextrans-2013-051147","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,14]],"date-time":"2024-05-14T13:20:09Z","timestamp":1715692809000},"score":1,"resource":{"primary":{"URL":"https:\/\/sti.bmj.com\/lookup\/doi\/10.1136\/sextrans-2013-051147"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,11,22]]},"references-count":29,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2014,2,12]]},"published-print":{"date-parts":[[2014,3]]}},"alternative-id":["10.1136\/sextrans-2013-051147"],"URL":"https:\/\/doi.org\/10.1136\/sextrans-2013-051147","relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.718186375.793488065","asserted-by":"object"}]},"ISSN":["1368-4973","1472-3263"],"issn-type":[{"value":"1368-4973","type":"print"},{"value":"1472-3263","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,11,22]]}}}