Risk prediction in sexual health contexts: protocol

Area of Science:

• Public Health and Epidemiology
• Digital Health and Telemedicine
• Infectious Disease Prevention

Background:

• Development of Get Checked Online (GCO), an internet-based program for sexually transmitted infections (STI) testing in British Columbia (BC).
• Limited understanding of effective risk assessment and test recommendation strategies for web-based STI testing.
• Established efficacy of prediction tools in enhancing STI case finding efficiency and cost-effectiveness.

Purpose of the Study:

• Derive a risk prediction rule for chlamydia and gonorrhea screening in public sexual health clinics.
• Evaluate the temporal generalizability of the prediction rule in Vancouver clinics (2007-2012).
• Assess the geographical generalizability of the rule across seven additional BC clinics.

Main Methods:

• Population-based, cross-sectional analysis of electronic health records from nine BC STI clinics (2000-2012).
• Multivariate logistic regression using clinic visit data (2000-2006) to derive a risk score for chlamydia and gonorrhea.
• Assessment of model discrimination (AUC) and calibration (Hosmer-Lemeshow), and evaluation of sensitivity and screening proportions at various risk score cutoffs.
• Temporal and geographical validation using data from 2007-2012.

Main Results:

• This is an ongoing research project.
• Initial results are anticipated in 2014.

Conclusions:

• Findings will inform the scale-up of internet-based STI testing in BC.
• A validated prediction rule could be integrated into GCO for individualized testing recommendations.
• The rule may enhance web-based educational materials, raising awareness of STI risk factors and promoting healthcare-seeking behavior.