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4A3 Performance Evaluation and Acceptability of POC TV Testing in Adult ED Female Patients

Thursday, September 22, 2016: 3:30 PM
Salon A
Mitra Lewis, MS1, Richard Rothman, MD, PhD1, Yu-Hsiang Hsieh, PhD1, Andrea Dugas, MD, PhD1, Stephen Peterson, BS1, Mary Jett-Goheen, BS MT(ASCP)2 and Charlotte Gaydos, MS, MPH, DrPH2, 1School of Medicine, Department of Emergency Medicine, Johns Hopkins University, Baltimore, MD, 2Department of Medicine, Division of Infectious Diseases, Johns Hopkins University, Baltimore, MD

     

Background: A majority of Emergency Departments (EDs) still rely on conventional insensitive diagnostics to detect Trichomonas Vaginalis (TV) infection and guide treatment. We evaluated the accuracy and perception of both provider-collected and patient self-completed point of care (POC) TV testing (facilitated by touch screen kiosk) in adult female ED patients.

Methods: A total of 150 patients undergoing gynecologic examination as part of their standard-of-care evaluation at Johns Hopkins ED were enrolled (July 2014 - May 2015). Participants completed a self-collected Trichomonas rapid test with kiosk-facilitation and completed surveys before and after self-testing. The clinician-collected POC TV test was performed by a study coordinator and results were given to the provider and participant. Descriptive analyses for frequencies and proportions were performed, along with McNemar’s test for participant acceptability data.  

Results: Participants were non-Hispanic (96.7%) Black/African American (88.7%) females. After completing the TV rapid self-test, 83% of women thought self-testing was “not at all hard” (compared with 66% before testing, p < .001). After comparing their self-test results with those of their clinician, 67% of participants believed that self-testing was as good as clinician testing. Furthermore, 83.3% of providers whose patient had a positive POC-TV result reported that rapid POC-TV testing impacted their management. Comparison of the provider-collected POC TV Test to the standard-of-care wet mount revealed 10 discordant results, resulting in an increased rate of detection from 9.8% (wet mount only) to 16.8% (POC-TV test). Participants demonstrated a high reading accuracy of their self-test: 100% accuracy for negative results and 96% accuracy for positive results.

Conclusions: Participants were able to reliably collect, perform, and read their own POC-TV test using kiosk instructions. Both patients and providers reported high levels of acceptability of POC-TV testing. POC-TV testing nearly doubled prevalence of detection of TV infection.

See more of: Clinical Controversies in Women's STD Care
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