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- AGREE, Appraisal of Guidelines Research and Evaluation instrument
- BASHH, British Association for Sexual Health and HIV
- BSIG, Bacterial Special Interest Group
- CEG, Clinical Effectiveness Group
- EIA, enzyme immunoassay
- ESR, erythrocyte sedimentation rate
- GUM, genitourinary medicine
- MSM, men who have sex with men
- NSU, non-specific urethritis
- PID, pelvic inflammatory disease
- STI, sexually transmitted infections
- TPHA, Treponema pallidum haemagglutination assay
- TPPA, Treponema pallidum particle assay
The Bacterial Special Interest Group (BSIG) of the British Association for Sexual Health and HIV (BASHH) was commissioned by the Clinical Effectiveness Group (CEG) to write screening and testing guidelines for use in UK genitourinary medicine (GUM) clinics. The aims of these guidelines are to:
provide advice on what tests for sexually transmitted diseases are most appropriate in a UK GUM clinic setting (excluding HIV infected patients)
provide a basis for audit
support clinics when bidding for additional resources to meet national standards.
Although designed for use by GUM clinics the recommendations may also provide information and guidance for other healthcare settings wishing to optimise the diagnosis of sexually transmitted infections (STI).
In compiling the guideline advice has been taken from a variety of different experts in the United Kingdom. The grade of evidence for each recommendation is given and it is evident that in many cases there is a lack of clinical trial data, which has led to the use of appropriate expert opinion. There is therefore a clear need for future research programmes to assess the efficacy of different approaches for STI screening and testing.
The levels of evidence and recommendations have been graded as shown below.
LEVELS OF EVIDENCE
Ia, evidence obtained from meta-analysis of randomised controlled trials
Ib, evidence obtained from at least one randomised controlled trial
IIa, evidence obtained from at least one well designed controlled study without randomisation
IIb, evidence obtained from at least one other type of well designed quasi-experimental study
III, evidence obtained from well designed non-experimental descriptive studies
IV, evidence obtained from expert committee reports or opinions and/or clinical experience of respected authorities.
GRADING OF RECOMMENDATION
A, evidence at level Ia or Ib
B, evidence at level IIa, IIb, or III
C, evidence at level IV.
The structure of the guideline is as follows:
Summary tables—that …