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As testing technologies evolve, they change clinical practice. Once upon a time, nearly all tests in the venereology clinic were ‘near patient’ or ‘point of care’ (POC) tests, though we didn't yet think of them in this way. Microscopy whether dark ground, wet preparation or Gram stained; the Wassermann reaction; the complex clinical phenomena of syphilis on which so much of the art of clinical examination was founded—all these were POC tests. With the advent of nucleic acid amplification tests, and the decline of morbidity due to syphilis, the time from test to diagnosis extended. It became less clear what an STI clinic had to offer a patient. In theory at least, most tests could be accessed through a GP or any other provider by a patient willing to wait a few days for the lab report. Chlamydia testing or screening programmes of several developed countries1 take it for granted that a week's wait for a diagnosis is of negligible public health impact, when measured against the benefits of …
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