Opt-out screening strategy for HIV infection among patients attending emergency departments: systematic review and meta-analysis
Autor: | N Cheyne, Paola Villafuerte-Gutierrez, José A. Pérez-Molina, Cesar Henriquez-Camacho, Juan Emilio Losa, Eduardo Gotuzzo |
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Rok vydání: | 2016 |
Předmět: |
HIV test
mass screening Male Pathology medicine.medical_specialty Human immunodeficiency virus (HIV) HIV Infections HIV screening tests medicine.disease_cause Human immunodeficiency virus prevalence 03 medical and health sciences 0302 clinical medicine Hiv test systematic review Human immunodeficiency virus infection purl.org/pe-repo/ocde/ford#3.03.02 [https] health care utilization Internal medicine purl.org/pe-repo/ocde/ford#3.03.08|https://purl.org/pe-repo/ocde/ford#3.01.055 [https] Humans Mass Screening Medicine Pharmacology (medical) human procedures 030212 general & internal medicine randomized controlled trial (topic) Mass screening Randomized Controlled Trials as Topic emergency ward patient attitude hospital emergency service business.industry Health Policy International health 030208 emergency & critical care medicine Patient Acceptance of Health Care female Infectious Diseases priority journal Meta-analysis Female Emergency Service Hospital business meta analysis |
Zdroj: | HIV Medicine. 18:419-429 |
ISSN: | 1464-2662 |
Popis: | Objectives International health agencies have promoted nontargeted universal (opt-out) HIV screening tests in different settings, including emergency departments (EDs). We performed a systematic review and meta-analysis to assess the testing uptake of strategies (opt-in targeted, opt-in nontargeted and opt-out) to detect new cases of HIV infection in EDs. Methods We searched the Pubmed and Embase databases, from 1984 to April 2015, for opt-in and opt-out HIV diagnostic strategies used in EDs. Randomized controlled or quasi experimental studies were included. We assessed the percentage of positive individuals tested for HIV infection in each programme (opt-in and opt-out strategies). The mean percentage was estimated by combining studies in a random-effect meta-analysis. The percentages of individuals tested in the programmes were compared in a random-effect meta-regression model. Data were analysed using stata version 12. Quality assessments were performed using the Newcastle−Ottawa Scale. Results Of the 90 papers identified, 28 were eligible for inclusion. Eight trials used opt-out, 18 trials used opt-in, and two trials used both to detect new cases of HIV infection. The test was accepted and taken by 75 155 of 172 237 patients (44%) in the opt-out strategy, and 73 581 of 382 992 patients (19%) in the opt-in strategy. The prevalence of HIV infection detected by the opt-out strategy was 0.40% (373 cases), that detected by the opt-in nontargeted strategy was 0.52% (419 cases), and that detected by the opt-in targeted strategy was 1.06% (52 cases). Conclusions In this meta-analysis, the testing uptake of the opt-out strategy was not different from that of the opt-in strategy to detect new cases of HIV infection in EDs. |
Databáze: | OpenAIRE |
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