Opt-Out Syphilis Screening in ED Improves Screening, Diagnosis

FRIDAY, Sept. 13, 2024 (HealthDay News) — Implementation of opt-out emergency department syphilis screening leads to a dramatic increase in screening and diagnosis, especially among pregnant individuals, according to a study published online Sept. 10 in Open Forum Infectious Diseases.

Kimberly A. Stanford, M.D., from University of Chicago, and colleagues examined trends in syphilis screening and diagnosis before and after implementation of an opt-out emergency department syphilis screening intervention in May 2019.

The researchers found that syphilis screening increased from 3.6 to 24.4 percent of encounters. Presumed active syphilis infection (PAI) increased 288 percent during the study period, from 161 patients (3.1 percent of those screened) to 624 patients (1.7 percent of those screened). Similarly, the proportion of women with PAI increased from 25.6 to 42.5 percent, despite no change in the proportion of women screened. Following implementation, 23.6 percent of PAI were tested for a urogenital sexually transmitted infection (STI) in the emergency department and 9.0 percent presented with symptoms of an STI by diagnosis code. Screening increased from 5.9 to 49.9 percent of encounters among pregnant people, and syphilis diagnosis increased 750 percent (from two cases to 15).

“Opt-out screening will be an important strategy in the effort to address the syphilis epidemic,” the authors write.

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