P1-S4.29 Synthesis of evidence on implementation research on point-of-care syphilis tests: a systematic review
Bibliographic record
Abstract
Background With the increase in global prevalence of syphilis, synthesis of evidence of point-of-care (POC) assays is warranted. While a clear methodology exists to meta-analyse diagnostic performance, a clear rubric that incorporates implementation research outcomes (IRO) relevant for policy making is lacking. Recently, Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group called for a shift to emphasis on patient-centred outcomes for making policy recommendations. However, a lack of clarity in defining, elucidating, and reporting of these outcomes prevents their utilisation in practice. Within this context, we reviewed global evidence on IROs for syphilis POC tests. Method We systematically searched nine electronic databases for the period of January 1980 to September 2010. Articles that addressed IRO regarding POC syphilis tests were reviewed and data extracted. A second reviewer independently reviewed a subset of the articles. Outcomes were synthesised into a narrative review. Results 31 (48%) from 64 full text articles assessed were included in the narrative review. Twenty-four studies were cross-sectional, six were case-control, while one was a clustered randomised control trial (RCT). IROs were categorised into: Acceptability, Preference, Feasibility, Prevalence, Barriers and Challenges, and Economic Evaluations of POC tests. Three papers reported outcomes on acceptability, four on preference, ten on feasibility, seven on impact, six on prevalence, seven on barriers and challenges, and seven on economic evaluations. Overall, studies were concordant on findings of high acceptability and feasibility of POC tests as well as the testing strategy used. Preference was not well demonstrated in studies. Impact was particularly well demonstrated in antenatal clinic attendees by a clustered RCT. Barriers and challenges ranged from biotechnological limitations of the tests to lack of political will. Heterogeneous methodologies employed across studies to conduct economic evaluations made it difficult to draw conclusive statements. Conclusions Results were generally in agreement across studies, yet unsystematic methods of collecting and recording outcomes made it difficult to statistically combine outcomes. Weaknesses in the reporting of IROs limit our ability to form comprehensive context-specific policies. Further efforts in establishing a framework for conducting implementation research is required.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.004 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".