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Computer system facilitated collection of STI information from teens
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BOSTON — Adolescents visiting a pediatric emergency department were more willing to disclose information about their sexual activity when filling out a computerized questionnaire, which were then used to determine testing for sexually transmitted infections, according to findings presented here during the 2012 Pediatric Academic Societies Annual Meeting.
Researchers at Washington University School of Medicine in St. Louis hypothesized that an Audio-enhanced Computer-Assisted Self-Interview (ACASI) could be used to increase STI testing in adolescents with indications for testing. To this end, researchers developed a computerized system to assess risk factors for Chlamydia and Neisseria gonorrhea infection in adolescents. Patients were eligible to complete the survey even if they were admitted to the ED for reasons unrelated to STIs.
“We wanted to take advantage of newer technology and communication methods to achieve better health outcomes for patients visiting the ED,” Fahd A. Ahmad, MD, a clinical and postdoctoral fellow in pediatric emergency medicine, said in a press release.
A total of 460 patients aged 15 to 21 years completed the survey, and the computer software provided a recommendation as to whether the adolescent should be tested for STIs based on a decision algorithm created by the research team. The recommendation and a summary of the patient’s answers were integrated in the electronic medical record to provide ED doctors and nurses with access to the information and order necessary tests.
“When we implemented the system, we found that almost half of the patients who completed the questionnaire were in need of STI testing, and that was the same whether their primary complaint was related to STIs,” Ahmad said.
Researchers also found that the overall rate of Chlamydia and N. gonorrhea testing in adolescents visiting the ED nearly doubled — from 8.8% to 15.1% — after the computerized survey was implemented compared with rates during the previous 15 months. Twenty percent of patients who were tested had an STI and received treatment, yet many of the patients did not receive testing as recommended for a variety of reasons.
Results demonstrated that it took a median of 8 minutes for patients to complete the survey. Ninety-one percent reported that the system was “very easy” or “easy” to use, while 83% reported they were “very comfortable” or “comfortable” with the system’s confidentiality. Additionally, 71% reported that they would actually prefer an electronic questionnaire over an in-person interview or written survey in future assessments.
“Computerized questionnaires are an efficient way for health care workers to collect clinically relevant information and integrate it into their practice,” Ahmad said. “This type of system could be expanded to other sensitive issues such as substance abuse.”
For more information:
- Ahmad FA. Abstract #1655.6. Presented at: 2012 PAS Annual Meeting; April 28-May 1, 2012; Boston.
Disclosure: Dr. Ahmad reported no relevant financial disclosures.