Population-Level Provider Compliance With Provincial Treatment Guidelines for the Management of Gonorrhea in Adolescents and Adults in Alberta, Canada; 2000 to 2019
Bibliographic record
Abstract
Background Appropriate antimicrobial therapy is one of the essential strategies in the global control of gonorrhea. We sought to determine the provider compliance with provincial treatment guidelines for gonococcal infections in Alberta, Canada, and to identify characteristics associated with provider noncompliance. Methods A retrospective population-based analysis of gonorrhea treatment from January 1, 2000, to December 31, 2019, using data extracted from a communicable disease database was performed. Prevalence ratios were calculated for provider compliance to treatment guidelines of patient, infection, and treating provider characteristics. Results We identified a total of 42,875 cases of gonorrhea, 58.3% were men, 40.3% were White, 28.2% were First Nations, and 16% were “unknown ethnicity.” Most cases were treated by family physicians (43.4%), sexually transmitted infection (STI) clinics (31.9%) and urgent care centers/hospitals (10%). Overall, there was 80.3% provider compliance with treatment guidelines. Provider compliance to treatment guidelines had the highest rates of compliance when treatment was provided by STI nurses in correctional facilities, STI clinics, and treatment of men having sex with men (94.7%, 91.7%, and 87.5%, respectively). Provider compliance to treatment guidelines was lowest when treating women (75.5%), pregnancy status (68.4), individuals of “unknown race/ethnicity” (74.8%), and those treated in urgent care centers and emergency department (66.7%). Conclusions Delivery of STI care by nurse-led models had the highest level of compliance with treatment guidelines. Our study informs areas for targeted interventions to improve the uptake of treatment guidelines, including the provision of treatment in urgent care centers and among women.
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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 | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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".