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首页> 外文期刊>Annals of Emergency Medicine: Journal of the American College of Emergency Physicians and the University Association for Emergency Medicine >HIV Screening In an Urban Emergency Department: Comparison of Screening Using an Opt-In Versus an Opt-Out Approach
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HIV Screening In an Urban Emergency Department: Comparison of Screening Using an Opt-In Versus an Opt-Out Approach

机译：城市急诊部门的艾滋病毒筛查：使用“选择加入”与“选择退出”方法进行筛查的比较

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Objective: We compare outcomes of opt-in and opt-out HiV screening approaches in an urban emergency department.Methods; This was a 1-year prospective observational study comparing 2 6-month screening approaches. Eligibility for opt-in and opt-out screening was identical: aged 15 years or older, medically stable, and able to complete general consent. During the opt-in phase, triage nurses referred patients to HIV testers stationed at triage, who obtained separate opt-in written consent and performed rapid oral fluid tests. During the opt-out phase, registration staff conducted integrated opt-out consent and then referred patients to HIV testers. We assessed the proportion of potentially eligible patients who were offered screening (screening offer rate), the proportion offered screening who accepted (screening acceptance rate), the proportion who accepted screening and subsequently completed testing (test completion rate), and the proportion of potentially eligible patients who completed testing (overall screening rate) during each phase.Results: For the opt-in versus the opt-out phases, respectively, there were 23,236 potentially eligible patients versus 26,757, screening offer rate was 27.9% versus 75.8% (P<.001), screening acceptance rate was 62.7% versus 30.9% (P<.001), test completion rate was 99.8% versus 74.6% (P<.001), and overall screening rate was 17.4% versus 17.5% (P=.90).Conclusion: A significantly higher proportion of patients were offered HIV screening with an opt-out approach at registration. However, this was offset by much higher screening acceptance and test completion rates with the opt-in approach at triage. Overall screening rates with the 2 approaches were nearly identical.
机译：目的：我们比较了城市急诊部门选择加入和选择退出HIV筛查方法的效果。这是一项为期1年的前瞻性观察性研究，比较了2种为期6个月的筛查方法。选择参加和选择退出筛查的资格是相同的：年龄在15岁或15岁以上，医疗状况稳定，并能够征得一般同意。在选择加入阶段，分诊护士将患者转至分诊的HIV测试人员，他们分别获得了选择加入的书面同意并进行了快速的口腔液体测试。在退出阶段，注册人员进行了全面的退出同意，然后将患者转介给HIV测试人员。我们评估了接受筛查的潜在合格患者的比例（筛查提供率），接受筛查的接受筛查的比例（筛查接受率），接受筛查并随后完成检测的比例（检测完成率）以及潜在筛查的比例在每个阶段完成测试（总体筛查率）的合格患者。结果：在选择进入和选择退出阶段，分别有23,236个潜在合格患者与26,757个患者相比，筛查提供率为27.9％对75.8％（P <.001），筛查接受率为62.7％对30.9％（P <.001），测试完成率为99.8％对74.6％（P <.001），总体筛查率为17.4％对17.5％（P = .90）。结论：登记注册时采用选择退出方法的HIV筛查患者比例要高得多。但是，采用分流的选择加入方法的更高的筛查接受率和测试完成率抵消了这一点。两种方法的总体筛查率几乎相同。

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