Doctor, why are you testing me for syphilis? I thought it was eradicated.

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We will discuss “Syphilis screening in pregnancy in the United Kingdom, 2010-2011: a national surveillance study.” by Townsend and co-workers from 31 August 2016 for 7 days.

*This paper will be made free-to-view  approximately 10 days before the start of #BlueJC. The published Journal Club guide can be found via this link.

We are now on LinkedIn too: http://linkd.in/1BVrpad (simply ask to join)!

Start date: 31 August 2016 (the discussion will open for 7 days between 31 August to 7 September 2016)

First hosted discussion session(s) on Twitter starts at: GMT+1 (British Summer Time) 8pm (using hashtag #BlueJC)

Host: @BlueJCHost

Platforms: Twitter, Facebook and LinkedIn 

BJOG_BlueJC_160x600WebBanner_Mar15_(reoriented)_3The Blue Journal Club is an international journal club on women’s health research based on Twitter (as @BlueJCHost). We start our conversation on the last Wednesday of every month and use the hashtag #BlueJC for our tweets. Simply add this hashtag (“#BlueJC”) to each tweet and we will capture it. Each #BlueJC opens for 7 days with an advertised start time. All BJOG #BlueJC papers also have complementary slide sets suitable for face-to-face journal clubs with your local colleagues. You can access the slide set of this paper here (click on the “supporting information” tab).

The discussion points are attached below (quoted from the published Journal Club guide)

Scenario

A healthy nulliparous woman attended her first antenatal visit. She was surprised when she was offered screening tests for sexually transmitted diseases, including syphilis. She asked, “Doctor, why are you testing me for so many sexually transmitted diseases? I thought nobody gets syphilis nowadays!” How would you address her concerns?

Description of research

Participants All pregnant women screened positive for syphilis between 2010 and 2011
Intervention Antenatal screening test for syphilis
Comparison Not applicable
Outcomes Proportion of screen-positive women with newly or previously confirmed diagnosis of syphilis

Proportion of women with newly or previously diagnosed syphilis requiring treatment in pregnancy

Study design Population-based cohort study
Authors’ conclusion One in four pregnant women screen-positive for syphilis in the UK had newly diagnosed syphilis (40% of them needed treatment).

Discussion Points

  • What is the epidemiology of syphilis in pregnancy in the UK? How does it compare to the rest of the world (See suggested reading)?
  • Using antenatal syphilis screening as an example, what are the differences between a screening test and a diagnostic test?
  • What was the proportion of women with false positive syphilis screening results?
  • What are the known factors associated with false positive syphilis screening?
  • What were the characteristics of women who were screened positive for syphilis and required treatment?
  • When were antibiotics initiated in women who required treatment for syphilis in pregnancy?
  • What advice would you give to the woman in the scenario?
  • How may the results of this study enhance your daily practice?

Suggested reading

  • Kingston M, et al; Members of the Syphilis guidelines revision group 2015. UK national guidelines on the management of syphilis 2015. Int J STD AIDS. 2016 May;27(6):421-46.Checklist 3.
  • Scottish Intercollegiate Guidelines Network (SIGN) Checklist for cohort studies. http://bit.ly/1rzfjfD.

For those who want to understand hashtags, this may be a useful guide. For an introduction to #BlueJC, please refer to BJOG 2013;120:657–60. Follow @BlueJCHostthis blog and our Facebook page to receive news about #BlueJC.

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