This article first appeared in the St. Louis Beacon, May 4, 2012 - A physician at Washington University has come up with an indirect way to have frank conversations with adolescents about the birds, the bees — and sexually transmitted infections or STIs.
Hundreds of thousands of people as young as 15 have STIs and are unaware they have been infected. Computer technology can help doctors and nurses get a handle on the problem, according to a study by Dr. Fahd A. Ahmad.
A clinical and postdoctoral fellow in pediatrics, he developed a system based on teens visiting the emergency department of St. Louis Children's Hospital seeking treatment for any number of illnesses.
Researchers involved in the study approached the youngsters about completing a computer survey on their sexual history. More than half agreed to participate. Based on the teens' survey responses, computer software was able to suggest whether the adolescents should be tested for chlamydia or gonorrhea. The computer recommendations also became part of each patient's electronic medical record, making it easy for emergency department doctors and nurses to access the information and order tests, if needed. About 20 percent of the women and 10 percent of the men who were tested turned out to be infected with one of the two targeted diseases.
Ahmad said the study offered doctors and nurses information they otherwise might never have known about patients, many of whom were getting emergency department treatment for conditions other than STIs.
"Kids who come to visit us in the emergency department might be at risk for an infection and don't know it," he said. "The doctors and nurses don't know the kids are at risk unless the kids come in complaining" about symptoms that suggest an STI.
Based on the survey results, the doctors and nurses might advise the patient that "since your doctor didn't have the test done, we'll do it while you are here today."
Timing is important, Ahmad says, because of the potential public health impact of STIs. Testing and treatment can prevent more serious health problems later on. He says that women who don't get treated can have severe health problems that affect their ability to have children later in life. He adds that testing and treatment also "prevent men and women from spreading infection back and forth."
When a patient arrives "with complaints that sounds like an infection, we're already really good at testing those kids," Ahmad says. "But when a lot of kids come in for problems that have nothing to do with infections, they are still at risk, and that's why this system is really helpful."
About 1,300 patients between the ages of 15 and 21 were approached about taking the survey, and more than 60 percent, or 801, agreed to participate over a nine-month period. He says youngsters tend to be computer savvy and seem willing to disclose experiences about their sexual activity to a laptop when taking a survey in a private setting. The median completion time of the survey was eight minutes, and 93 percent of the participants rated the computer program easy-to-very easy to use, according to the research.
Ahmad thinks the program has been beneficial because some potential STIs cases among adolescents using the emergency department might again go undetected among youngsters being treated for conditions unrelated to STIs.
"We are able to get information from patients that we otherwise wouldn't get," he said. We turned off the system in December and when we did that, the doctors and nurses went back to their old routine. They'd ask the question of kids only in cases where they were worrying about infection. Without the system, a lot of kids won't get tested."
