Self Sampling for Rapid Turnaround Testing in the Emergency Department

NCT ID: NCT03676816

Last Updated: 2021-08-05

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

533 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-09-17

Study Completion Date

2020-06-09

Brief Summary

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Consenting adult female patient felt by the provider to require gonorrhea/chlamydia endocervical testing will be asked to provide an additional self sample specimen. The specimen will be sent to the laboratory using conventional diagnostic test for gonorrhea/chlamydia.

Detailed Description

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Study protocol:

1. Initial emergency department history and physical examination (standard procedure).

a. Provider identifies patient who is felt to require gonorrhea/chlamydia testing.

i. Provider will contact study staff to consent patient. b. Study staff identifies patient who is felt by provider to require gonorrhea/chlamydia testing. i. Study staff will ask provider if they could move forward with consenting patient.

c. Provider who is study staff identifies patient who is felt to require gonorrhea/chlamydia testing.
2. Study staff will attempt to consent patient.

1. If inclusion criteria are met, and there are no exclusion criteria, written informed consent is obtained.
2. If the patient changes her mind and refuses consent at this point, a notation is written on the front of the research packet, and it is turned in with a refusal notice on the packet.

* If patient refuses to participate in the self-sampling portion of the study, we will ask patients if they would like to fill out the first half of the patient survey that will contain no personal identification information besides their initials.
3. If patient agrees to participate in the self-sampling, the patient is asked to fill out both page one and page two of the survey after consent is obtained.
4. An attempt is made to write down at least two contact telephone numbers for patients who have given informed consent on page 2 of the patient survey.
5. The patient obtains vaginal self-sample in the restroom/exam room.

1. A preprinted single-use instruction sheet is given to patient detailing sample collection.
2. Vaginal self-sampling collection container has preprinted instructions/requisition and a preprinted label on the Cepheid sample tube to the lab denoting this as research sample.
3. Paper requisition form is also included with the sample which helps with documentation and assigning this sample to be billed to the research study and not to the patient.
4. The patient returns the collection container after obtaining the sample to study staff that consented the patient.
5. The collection container will be sent to the lab via pneumatic tube station.
6. Vaginal self-sampling result is documented in Epic with designation showing differentiation from provider-performed endocervical sampling.
6. Provider-performed endocervical sampling is performed once the patient is assigned a provider and given a private area to conduct a provider-performed endocervical sampling (standard procedure).

a. The collection container is sent to the lab, and the final result is noted in the medical record as per standard practice (standard procedure).
7. Retrospective chart review is performed three days after patient consented in order to obtain provider-performed endocervical sampling results.
8. Patient will be contacted only if there is a false-negative. A positive with either the self-sample or provider collected sample is considered positive, and patient will not be called back about that

Conditions

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Chlamydia Trachomatis Neisseria Gonorrhoeae

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Vaginal self-sampling and provider performed endocervical sampling

Patients will take part in both provider-performed endocervical sampling (standard care) and vaginal self-sampling.

Group Type EXPERIMENTAL

vaginal self sampling

Intervention Type PROCEDURE

This is a prospective, non-inferiority trial comparing two methods of collection using a US Food and Drug Administration- cleared 90-minute rapid nucleic acid amplification assay, the Xpert CT/NG assay. Any adult female patient admitted to the Emergency Department at Community Regional Medical Center felt by the provider to require gonorrhea/chlamydia endocervical testing may be entered in the study.

provider-performed endocervical sampling

Intervention Type PROCEDURE

provider-performed endocervical sampling is the gold standard for both gonorrhea and chlamydia. The provider takes a endocervical sample which will get sent to the laboratory as the standard care in comparison to the device being studied.

Interventions

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vaginal self sampling

This is a prospective, non-inferiority trial comparing two methods of collection using a US Food and Drug Administration- cleared 90-minute rapid nucleic acid amplification assay, the Xpert CT/NG assay. Any adult female patient admitted to the Emergency Department at Community Regional Medical Center felt by the provider to require gonorrhea/chlamydia endocervical testing may be entered in the study.

Intervention Type PROCEDURE

provider-performed endocervical sampling

provider-performed endocervical sampling is the gold standard for both gonorrhea and chlamydia. The provider takes a endocervical sample which will get sent to the laboratory as the standard care in comparison to the device being studied.

Intervention Type PROCEDURE

Other Intervention Names

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Cepheid, SWAB/A-50

Eligibility Criteria

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Inclusion Criteria

* Adult female emergency department patient felt by the provider to require gonorrhea/chlamydia endocervical testing

Exclusion Criteria

* Non-English speakers with the exception of Spanish speakers (once a Spanish-language informed consent document is approved by the Community Medical Center Institutional Review Board)
* Prisoner
* Age \<18 years old
* Active psychiatric condition felt to preclude the ability to give informed consent
* Treated for gonorrhea/chlamydia within previous four weeks
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Central California Faculty Medical Group

OTHER

Sponsor Role collaborator

University of California, San Francisco

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Brian Chinnock, MD

Role: PRINCIPAL_INVESTIGATOR

UCSF - Fresno

Locations

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Community Regional Trauma and Burn Center

Fresno, California, United States

Site Status

Countries

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United States

References

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Levitt MA, Johnson S, Engelstad L, Montana R, Stewart S. Clinical management of chlamydia and gonorrhea infection in a county teaching emergency department--concerns in overtreatment, undertreatment, and follow-up treatment success. J Emerg Med. 2003 Jul;25(1):7-11. doi: 10.1016/s0736-4679(03)00131-8.

Reference Type BACKGROUND
PMID: 12865101 (View on PubMed)

Huppert JS, Taylor RG, St Cyr S, Hesse EA, Reed JL. Point-of-care testing improves accuracy of STI care in an emergency department. Sex Transm Infect. 2013 Sep;89(6):489-94. doi: 10.1136/sextrans-2012-050994. Epub 2013 Mar 7.

Reference Type BACKGROUND
PMID: 23471445 (View on PubMed)

Holley CE, Van Pham T, Mezzadra HM, Willis GC, Witting MD. Overtreatment of gonorrhea and chlamydial infections in 2 inner-city emergency departments. Am J Emerg Med. 2015 Sep;33(9):1265-8. doi: 10.1016/j.ajem.2015.06.009. Epub 2015 Jun 12.

Reference Type BACKGROUND
PMID: 26119905 (View on PubMed)

Terkelsen D, Tolstrup J, Johnsen CH, Lund O, Larsen HK, Worning P, Unemo M, Westh H. Multidrug-resistant Neisseria gonorrhoeae infection with ceftriaxone resistance and intermediate resistance to azithromycin, Denmark, 2017. Euro Surveill. 2017 Oct;22(42):17-00659. doi: 10.2807/1560-7917.ES.2017.22.42.17-00659.

Reference Type BACKGROUND
PMID: 29067905 (View on PubMed)

Katz AR, Komeya AY, Kirkcaldy RD, Whelen AC, Soge OO, Papp JR, Kersh EN, Wasserman GM, O'Connor NP, O'Brien PS, Sato DT, Maningas EV, Kunimoto GY, Tomas JE. Cluster of Neisseria gonorrhoeae Isolates With High-level Azithromycin Resistance and Decreased Ceftriaxone Susceptibility, Hawaii, 2016. Clin Infect Dis. 2017 Sep 15;65(6):918-923. doi: 10.1093/cid/cix485.

Reference Type BACKGROUND
PMID: 28549097 (View on PubMed)

Nelson EJ, Maynard BR, Loux T, Fatla J, Gordon R, Arnold LD. The acceptability of self-sampled screening for HPV DNA: a systematic review and meta-analysis. Sex Transm Infect. 2017 Feb;93(1):56-61. doi: 10.1136/sextrans-2016-052609. Epub 2016 Oct 19.

Reference Type BACKGROUND
PMID: 28100761 (View on PubMed)

Other Identifiers

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2018045

Identifier Type: -

Identifier Source: org_study_id

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