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Lin J, Whitlock E, O'Connor E, et al. Behavioral Counseling to Prevent Sexually Transmitted Infections [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Oct. (Evidence Syntheses, No. 64.)

  • This publication is provided for historical reference only and the information may be out of date.

This publication is provided for historical reference only and the information may be out of date.

Appendix A: Methods

Table 1. Search strategies

Systematic Evidence Review Search

PubMed search to identify systematic reviews

#115 Search #114 NOT (case report [ti] OR editorial [ti] OR editorial [pt] OR letter [pt] OR newspaper article [pt])

#114 Search #80 NOT #62 Field: All Fields, Limits: English

#113 Search #112 NOT (case report [ti] OR editorial [ti] OR editorial [pt] OR letter [pt] OR newspaper article [pt]) Limits: English

#112 Search #61 NOT #59 Field: All Fields, Limits: English

#111 Search #57 AND #58 NOT (case report [ti] OR editorial [ti] OR editorial [pt] OR letter [pt] OR newspaper article [pt]) Limits: English

#110 Search #57 AND #58 Field: All Fields, Limits: English

#108 Search #107 AND (in process [sb] OR publisher [sb])

#107 Search #106 AND #58

#106 Search #101 AND #105

#105 Search #52 OR #53 OR #54 OR #55 OR #102 OR #103 OR #104

#104 Search “patient education”[tiab]

#103 Search “health education”[tiab]

#102 Search “health promotion”[tiab]

#101 Search #82 OR #83 OR #84 OR #85 OR #86 OR #87 OR #88 OR #89 OR #90 OR #91 OR #92 OR #93 OR #94 OR #95 OR #96 OR #97 OR #98 OR #99 OR #100

#100 Search “sexually transmitted”[tiab]

#99 Search stis[tiab]

#98 Search sti[tiab]

#97 Search stds[tiab]

#96 Search std[tiab]

#95 Search syphilis[tiab]

#94 Search gonorrhea[tiab]

#93 Search chlamydia[tiab]

#92 Search hpv[tiab]

#91 Search “human papillomavirus”[tiab]

#90 Search “genital warts”[tiab]

#89 Search “condylomata acuminata”[tiab]

#88 Search hsv[tiab]

#87 Search “genital herpes”[tiab]

#86 Search “herpes simplex”[tiab]

#85 Search “hepatitis c”[tiab]

#84 Search “hepatitis b”[tiab]

#83 Search aids[tiab]

#82 Search hiv[tiab]

#81 Search #80 NOT #62

#80 Search #79 NOT #59

#79 Search #78 AND #58

#78 Search #63 OR #64 OR #65 OR #66 OR #67 OR #68 OR #69 OR #70 OR #71 OR #72 OR #73 OR #74 OR #75 OR #76 OR #77

#77 Search “Sexually Transmitted Diseases, Viral/prevention and control”[MeSH:NoExp]

#76 Search “Sexually Transmitted Diseases, Bacterial/prevention and control”[MeSH:NoExp]

#75 Search “Sexually Transmitted Diseases/prevention and control”[MeSH:NoExp]

#74 Search “Syphilis/prevention and control”[MeSH:NoExp]

#73 Search “Gonorrhea/prevention and control”[MeSH]

#72 Search “Chlamydia Infections/prevention and control”[MeSH:NoExp]

#71 Search “Condylomata Acuminata/prevention and control”[MeSH]

#70 Search “Herpes Genitalis/prevention and control”[MeSH]

#69 Search “Herpes Simplex/prevention and control”[MeSH:NoExp]

#68 Search “Hepatitis C, Chronic/prevention and control”[MeSH]

#67 Search “Hepatitis C/prevention and control”[MeSH:NoExp]

#66 Search “Hepatitis B, Chronic/prevention and control”[MeSH]

#65 Search “Hepatitis B/prevention and control”[MeSH:NoExp]

#64 Search “Acquired Immunodeficiency Syndrome/prevention and control”[MeSH]

#63 Search “HIV Infections/prevention and control”[MeSH:NoExp]

#62 Search #61 NOT #59

#61 Search #60 AND #58

#60 Search #40 AND intervention*[tiab]

#59 Search #57 AND #58

#58 Search systematic review* [tiab] OR systematic literature review* OR meta-analysis [pt] OR meta-analysis [ti] OR metaanalysis [ti] OR meta-analyses [ti] OR evidence-based medicine OR (evidence-based AND (guideline [tiab] OR guidelines [tiab] OR recommendations)) OR (evidenced-based AND (guideline [tiab] OR guidelines [tiab] OR recommendation*)) OR consensus development conference [pt] OR health planning guidelines OR guideline[pt] OR cochrane database syst rev OR acp journal club OR health technol assess OR evid rep technol assess summ OR evid based dent OR evid based nurs OR evid based ment health OR clin evid

#57 Search #40 AND #56

#56 Search #41 OR #42 OR #43 OR #44 OR #45 OR #46 OR #47 OR #48 OR #49 OR #50 OR #51 OR #52 OR #53 OR #54 OR #55

#55 Search “motivational interview*”[tiab]

#54 Search advise[tiab]

#53 Search advice[tiab]

#52 Search counsel*[tiab]

#51 Search “teaching materials” [MeSH:NoExp]

#50 Search “student health services” [MeSH:NoExp]

#49 Search “preventive health services” [MeSH:NoExp]

#48 Search “physician's role” [MeSH:NoExp]

#47 Search “behavior therapy” [MeSH:NoExp]

#46 Search “cognitive therapy” [MeSH:NoExp]

#45 Search “directive counseling” [MeSH:NoExp]

#44 Search “counseling” [MeSH:NoExp]

#43 Search “patient education” [MeSH:NoExp]

#42 Search “health education” [MeSH:NoExp]

#41 Search “health promotion” [MeSH:NoExp]

#40 Search #25 OR #26 OR #27 OR #28 OR #29 OR #30 OR #31 OR #32 OR #33 OR #34 OR #35 OR #36 OR #37 OR #38 OR #39

#39 Search “Sexually Transmitted Diseases, Viral”[MeSH:NoExp]

#38 Search “Sexually Transmitted Diseases, Bacterial”[MeSH:NoExp]

#37 Search “Sexually Transmitted Diseases”[MeSH:NoExp]

#36 Search “Syphilis”[MeSH:NoExp]

#35 Search “Gonorrhea”[MeSH]

#34 Search “Chlamydia Infections”[MeSH:NoExp]

#33 Search “Condylomata Acuminata”[MeSH]

#32 Search “Herpes Genitalis”[MeSH]

#31 Search “Herpes Simplex”[MeSH:NoExp]

#30 Search “Hepatitis C, Chronic”[MeSH]

#29 Search “Hepatitis C”[MeSH:NoExp]

#28 Search “Hepatitis B, Chronic”[MeSH]

#27 Search “Hepatitis B”[MeSH:NoExp]

#26 Search “Acquired Immunodeficiency Syndrome”[MeSH]

#25 Search “HIV Infections”[MeSH:NoExp]

Key Questions 1, 2, 3, 4

Database: Ovid MEDLINE(R) <1966 to December 31 2006>

Search Strategy:

--------------------------------------------------------------------------------

1.

HIV Infections/

2.

Acquired Immunodeficiency Syndrome/

3.

Hepatitis B/

4.

Hepatitis B, Chronic/

5.

Hepatitis C/

6.

Hepatitis C, Chronic/

7.

Herpes Simplex/

8.

Herpes Genitalis/

9.

Herpes Labialis/

10.

Condylomata Acuminata/

11.

Warts/

12.

Chlamydia Infections/

13.

Gonorrhea/

14.

Syphilis/

15.

Papillomavirus Infections/

16.

Papillomavirus, Human/

17.

Human papillomavirus 6/

18.

Human papillomavirus 11/

19.

Human papillomavirus 16/

20.

Human papillomavirus 18/

21.

Trichomonas Infections/

22.

Trichomonas Vaginitis/

23.

Sexually Transmitted Diseases/

24.

Sexually Transmitted Diseases, Bacterial/

25.

Sexually Transmitted Diseases, Viral/

26.

1 or 2 or 3 or 4 or 5 or 6 or 7 or 8 or 9 or 10 or 11 or 12 or 13 or 14 or 15 or 16 or 17 or 18 or 19 or 20 or 21 or 22 or 23 or 24 or 25

27.

health promotion/

28.

health education/

29.

patient education/

30.

counseling/

31.

directive counseling/

32.

cognitive therapy/

33.

behavior therapy/

34.

physician's role/

35.

preventive health services/

36.

student health services/

37.

teaching materials/

38.

counsel$.ti,ab.

39.

advice.ti,ab.

40.

advise.ti,ab.

41.

motivational interview$.ti,ab.

42.

prevention intervention$.ti,ab.

43.

27 or 28 or 29 or 30 or 31 or 32 or 33 or 34 or 35 or 36 or 37 or 38 or 39 or 40 or 41 or 42

44.

26 and 43

45.

Safe Sex/

46.

Unsafe Sex/

47.

Sexual Behavior/

48.

45 or 46 or 47)

49.

43 and 48

50.

HIV Infections/pc [Prevention & Control]

51.

Acquired Immunodeficiency Syndrome/pc [Prevention & Control]

52.

Hepatitis B/pc [Prevention & Control]

53.

Hepatitis B, Chronic/pc [Prevention & Control]

54.

Hepatitis C/pc [Prevention & Control]

55.

Hepatitis C, Chronic/pc [Prevention & Control]

56.

Herpes Simplex/pc [Prevention & Control]

57.

Herpes Genitalis/pc [Prevention & Control]

58.

Herpes Labialis/pc [Prevention & Control]

59.

Condylomata Acuminata/pc [Prevention & Control]

60.

Warts/pc [Prevention & Control]

61.

Chlamydia Infections/pc [Prevention & Control]

62.

Gonorrhea/pc [Prevention & Control]

63.

Syphilis/pc [Prevention & Control]

64.

Papillomavirus Infections/pc [Prevention & Control]

65.

Trichomonas Infections/pc [Prevention & Control]

66.

Trichomonas Vaginitis/pc [Prevention & Control]

67.

Sexually Transmitted Diseases/pc [Prevention & Control]

68.

Sexually Transmitted Diseases, Bacterial/pc [Prevention & Control]

69.

Sexually Transmitted Diseases, Viral/pc [Prevention & Control]

70.

50 or 51 or 52 or 53 or 54 or 55 or 56 or 57 or 58 or 59 or 60 or 61 or 62 or 63 or 64 or 65 or 66 or 67 or 68 or 69

71.

intervention$.ti,ab,hw.

72.

70 and 71

73.

44 or 49 or 72

74.

limit 73 to (clinical trial or controlled clinical trial or randomized controlled trial)

75.

clinical trials/ or controlled clinical trials/ or randomized controlled trials/

76.

double-blind method/ or random allocation/ or single-blind method/

77.

random$.ti,ab.

78.

75 or 76 or 77

79.

73 and 78

80.

74 or 79

81.

limit 80 to english language

82.

limit 81 to yr=“1983 - 2006”

Database: PsycINFO <1985 to April Week 3 2006>

Search Strategy:

--------------------------------------------------------------------------------

1.

sexually transmitted diseases/

2.

Acquired Immune Deficiency Syndrome/

3.

Human Immunodeficiency Virus/

4.

GONORRHEA/

5.

HERPES GENITALIS/

6.

HERPES SIMPLEX/

7.

AIDS Prevention/

8.

SYPHILIS/

9.

HEPATITIS/

10.

Sexual Risk Taking/

11.

safe sex/

12.

Psychosexual Behavior/

13.

sexually transmitted.ti,ab,id. [title,abstract,key concept]

14.

aids.ti,ab,id.

15.

hiv.ti,ab,id.

16.

hepatitis b.ti,ab,id.

17.

hepatitis c.ti,ab,id.

18.

herpes.ti,ab,id.

19.

condylomata acuminata.ti,ab,id.

20.

warts.ti,ab,id.

21.

chlamydia.ti,ab,id.

22.

gonorrhea.ti,ab,id.

23.

papillomavirus.ti,ab,id.

24.

hpv.ti,ab,id.

25.

trichomonas.ti,ab,id.

26.

syphilis.ti,ab,id.

27.

1 or 2 or 3 or 4 or 5 or 6 or 7 or 8 or 9 or 10 or 11 or 12 or 13 or 14 or 15 or 16 or 17 or 18 or 19 or 20 or 21 or 22 or 23 or 24 or 25 or 26

28.

Health Education/

29.

Health Promotion/

30.

Behavior Therapy/

31.

Behavior Change/

32.

Behavior Modification/

33.

Client Education/

34.

COUNSELING/

35.

Preventive Medicine/

36.

student personnel services/

37.

Lifestyle Changes/

38.

advice.ti,ab,id.

39.

advise.ti,ab,id.

40.

counsel$.ti,ab,id,hw. [title,abstract,key concept,subject heading word]

41.

prevention intervention$.ti,ab,id,hw.

42.

motivational interview$.ti,ab,id,hw.

43.

behavio$ intervention$.ti,ab,id,hw.

44.

Health Behavior/

45.

44 and intervention$.ti,ab,id,hw.

46.

health promotion.ti,ab,id.

47.

health education.ti,ab,id.

48.

behavio$ therapy.ti,ab,id.

49.

behavio$ change$.ti,ab,id.

50.

behavio$ modification$.ti,ab,id.

51.

client education.ti,ab,id.

52.

28 or 29 or 30 or 31 or 32 or 33 or 34 or 35 or 36 or 37 or 38 or 39 or 40 or 41 or 42 or 43 or 45 or 46 or 47 or 48 or 49 or 50 or 51

53.

27 and 52

54.

random$.ti,ab,id,hw.

55.

clinical trial$.ti,ab,id,hw.

56.

controlled trial$.ti,ab,id,hw.

57.

54 or 55 or 56

58.

53 and 57

59.

limit 58 to english language

60.

limit 59 to yr=“1988 - 2007”

Database: EBM Reviews - Cochrane Central Register of Controlled Trials <4th Quarter 2006>

Search Strategy:

--------------------------------------------------------------------------------

1.

sexually transmitted.ti,ab,hw.

2.

hiv.ti,ab,hw.

3.

acquired immunodeficiency.ti,ab,hw.

4.

human immunodeficiency virus.ti,ab,hw.

5.

acquired immune deficiency.ti,ab,hw.

6.

hepatitis b.ti,ab,hw.

7.

hepatitis c.ti,ab,hw.

8.

hpv.ti,ab,hw.

9.

papillomavirus.ti,ab,hw.

10.

trichomonas.ti,ab,hw.

11.

syphilis.ti,ab,hw.

12.

gonorrhea.ti,ab,hw.

13.

chlamydia.ti,ab,hw.

14.

hsv.ti,ab,hw.

15.

herpes simplex.ti,ab,hw.

16.

condylomata.ti,ab,hw.

17.

warts.ti,ab,hw.

18.

herpes genitalis.ti,ab,hw.

19.

herpes labialis.ti,ab,hw.

20.

safe sex.ti,ab,hw.

21.

unsafe sex.ti,ab,hw.

22.

sexual behavio$.ti,ab,hw.

23.

1 or 2 or 3 or 4 or 5 or 6 or 7 or 8 or 9 or 10 or 11 or 12 or 13 or 14 or 15 or 16 or 17 or 18 or 19 or 20 or 21 or 22

24.

health promotion.ti,ab,hw.

25.

health education.ti,ab,hw.

26.

patient education.ti,ab,hw.

27.

counsel$.ti,ab,hw.

28.

advice.ti,ab,hw.

29.

advise.ti,ab,hw.

30.

motivational interview$.ti,ab,hw.

31.

prevention intervention$.ti,ab,hw.

32.

cognitive therapy.ti,ab,hw.

33.

physician's role.ti,ab,hw.

34.

preventive health services.ti,ab,hw.

35.

student health services.ti,ab,hw.

36.

teaching materials.ti,ab,hw.

37.

behavio$ intervention$.ti,ab,hw.

38.

behavio$ therapy.ti,ab,hw.

39.

behavio$ change$.ti,ab,hw.

40.

behavio$ modification$.ti,ab,hw.

41.

client education.ti,ab,hw.

42.

preventive medicine.ti,ab,hw.

43.

(health behavio$ and intervention$).ti,ab,hw.

44.

24 or 25 or 26 or 27 or 28 or 29 or 30 or 31 or 32 or 33 or 34 or 35 or 36 or 37 or 38 or 39 or 40 or 41 or 42 or 43

45.

23 and 44

46.

limit 45 to yr=“1988 - 2005”

Key Question 5

Database: Ovid MEDLINE(R) <1966 to December 31 2006>

Search Strategy:

--------------------------------------------------------------------------------

1.

Condoms, Female/

2.

female condom$.ti,ab.

3.

1 or 2

4.

Disease Transmission/

5.

Incidence/

6.

incidence.ti,ab.

7.

disease prevention.ti,ab.

8.

efficac$.ti,ab.

9.

effective$.ti,ab.

10.

(epidemiology or prevention control or transmission).fs.

11.

4 or 5 or 6 or 7 or 8 or 9 or 10

12.

3 and 11

13.

limit 12 to english language

14.

limit 13 to yr=“1988 - 2006”

Database: EBM Reviews - Cochrane Central Register of Controlled Trials <3rd Quarter 2006>

Search Strategy:

--------------------------------------------------------------------------------

1.

condoms, female/

2.

female condom$.ti,ab.

3.

1 or 2

Table 2. Inclusion/exclusion criteria

Definition of STI and included diseases

Inclusions

An STI (sexually transmitted infection) is a bacterial or viral illness that is transmitted through sexual contact, including, but not limited to, anal, vaginal, or oral sex. Infections include, but are not limited to:

  • HIV
  • Hepatitis B
  • Hepatitis C
  • Herpes simplex virus (HSV) (1 and 2)
  • Human papillomavirus (HPV)
  • Chlamydia
  • Gonorrhea
  • Syphilis
  • Trichomonas

Exclusions

There are other methods by which the bloodborne STIs (HIV, hepatitis B and C) can be acquired. These methods include maternal-fetal transmission, transfusions, inadvertent needlesticks, and sharing needles or injection equipment with an infected person. These methods of transmission, and the counseling measures that could potentially reduce them, will not be included in the Task Force's research or final recommendations.

Interventions

This review will only systematically examine sexual behavioral counseling interventions. Other types of preventive interventions will only be referenced if offered with counseling targeting sexual behavior change. There are a number of counseling intervention options that have been studied. A useful way to group types of interventions for the purpose of USPSTF recommendations is to classify them by: 1) primary care feasible or conducted, 2) primary care referable, 3) community non-referral, which includes population-based interventions.

Our review of the literature will consider health care system influences related to counseling interventions. Health-care-system interventions, however, is not included as a separate category for inclusion.

Inclusions

1.

Primary care feasible or conducted

Behavioral counseling interventions must have been conducted in a primary care research setting or judged to be feasible in ‘usual’ primary care.

i.

Target: involve individual-level identification of being a patient or in need of intervention

ii.

Delivery: usually involve primary care physicians, other physicians, nurses, nurse practitioners, physician assistants, or related clinical staff (i.e. health educators, other counselors); OR, the intervention will be seen as connected to the health care system by the participant

iii.

Format: to individuals or small groups (i.e., 15 or less); do not primarily involve group-level interventions outside the primary care setting; generally does not involve more than eight group sessions and the intervention period is no longer than 12 months

iv.

Location: anywhere, as long as linked to primary care (as outlined above)

v.

Examples: could include any number of behavioral intervention (e.g., cognitive behavioral counseling, motivational enhancement activities, skills training, and counseling plus testing or plus provision of condoms)

2.

Primary care referable:

  • In order to be feasible for primary care referral, the intervention needs to be conducted as part of a healthcare setting, or be widely available in the community at a national level.

Exclusions

1.

Community, non-referral

i.

Community programs (i.e. worksite programs, school programs)

ii.

Social marketing (i.e. media campaigns)

iii.

Policy (i.e. local and state public or health policy)

Settings

Inclusions

Primary care settings (including pediatric, OB/GYN, internal medicine, family practice, family planning, military, adolescent and school based health clinics) in the United States. Mental health clinics will be included to the extent that they provide primary care is being addressed in these clinics.

Research based at specialty clinics, including STI, GU clinics, and HIV testing sites should be considered if little evidence based in the primary care office setting is available.

Research based in other English speaking industrialized countries, as defined by United Nations' Human Development Index 1 countries, should be considered if little evidence based in the United States. We will include research based in any country for key question 5.

Exclusions

Correctional facilities, school-based programs, substance abuse treatment facilities, HIV clinics, inpatient hospital units, and community-based groups and activities centered outside the primary care clinician's customary work setting.

Research based in developing countries, as defined by the Human Development Index.

Populations

Inclusions

When possible, key questions will be addressed for each population separately:

1.

Adults:

a.

General population- Female, Male

b.

High-risk- Female, Male

2.

Adolescents (12 to 18 years old or as defined by trial):

a.

Sexually active- Female, Male

b.

Pre-sexual debut- Female, Male

3.

Pregnant women

The definition of “high-risk” is complex and is approached in numerous ways within the literature. Our definition of “high-risk” is consistent with that used in the USPSTF STI and HIV screening recommendations. These high-risk groups include both behavioral risk factors and demographic risks.

1.

Behavior-based (modifiable):

a.

Multiple sexual partners

b.

Infected partner or high-risk partner

c.

Inconsistent or improper use of barrier contraception

d.

Abuses drugs/ has sexual relations under the influence of mind-altering substances

e.

Exchanges sex for drugs or money

2.

Demographic-based (non-modifiable):

High-risk persons have also been identified by subpopulation based upon total prevalence of STIs within that group. Studies using subpopulations to classify risk have identified periodically vulnerable groups, including:

a.

African Americans (both male and female)

b.

Latinos (both male and female)

c.

Adolescents and young adults (under 25 years old)

d.

Intravenous drug users (IDUs) or previous IDUs

e.

Men who have sex with men (MSM)

f.

Sex workers

g.

The mentally ill

h.

The mentally disabled

i.

Low-income persons in urban settings

j.

Inmates or former inmates

k.

Military recruits

l.

High number of total lifetime sexual partners

m.

Previous or present history of STI

Exclusions

Persons with HIV

Study Design

Inclusions

English language only. For key questions 1, 2, 3, 4 only include randomized controlled trials and non-randomized controlled trials published after 1987 (1988- present).

For key question 5, we will include cohort studies (prospective, retrospective) and nested case-control studies. Depending on the evidence available to adequately address key question 3, we may include cross-sectional and case-control studies.

Exclusions

For key questions 1, 2, 3, 4 we will exclude all observational studies.

For key question 5, we will exclude mathematical modeling.

Outcomes

Inclusions

Trials with outcome assessment of greater than 60% of participants with a minimum of a three-month follow-up.

1.

Sexual behavior changes

a.

Risky behaviors (e.g., multiple (new) partners; high-risk partners; UAI, UVI, or other contact with bodily fluids; sex while intoxicated with alcohol or other substances; sex in exchange for money or drugs)

b.

Protective behaviors (e.g, abstinence; mutual monogamy; delay initiation of intercourse or age of sexual debut; decrease contact with bodily fluids with male condom, other physical barrier methods, chemical barriers, or other changes in sexual behavior)

2.

STI incidence and related morbidity and mortality

a.

Symptomatic and asymptomatic infection (i.e. testing, self-report)

b.

Major sequelae of STIs (as outlined by the Institute of Medicine, 1997)

Exclusions

Any trial with greater than 40% attrition or no outcome assessment beyond three months.

1.

Attitude, knowledge, ability changes and self efficacy including, but not limited to:

a.

STI risk and transmission knowledge, knowledge of protective behaviors

b.

Perception of HIV/STI risk in self or partners

c.

Regretted intercourse

d.

Participation in AIDS-related community activities

e.

Sexual negotiation skills (for condom use or saying “no”)/perceived powerlessness

f.

Scheduling a health-care appointment or discussing its importance with family

g.

Intention to use protective barriers

h.

Carrying barrier protection

2.

Self-esteem

Table 3. USPSTF hierarchy of research design and quality rating criteria1

Hierarchy of Research Design

  • I Properly conducted randomized controlled trial (RCT)
  • II-1: Well-designed controlled trial without randomization
  • II-2: Well-designed cohort or case-control analytic study
  • II-3: Multiple time series with or without the intervention; dramatic results from uncontrolled experiments
  • III: Opinions of respected authorities, based on clinical experience; descriptive studies or case reports; reports of expert committees

Design-Specific Criteria

Systematic Reviews

Criteria

  • Comprehensiveness of sources considered/search strategy used
  • Standard appraisal of included studies
  • Validity of conclusions
  • Recency and relevance are especially important for systematic reviews

Case-Control Studies

Criteria

  • Accurate ascertainment of cases
  • Nonbiased selection of cases/controls with exclusion criteria applied equally to both
  • Response rate
  • Diagnostic testing procedures applied equally to each group
  • Measurement of exposure accurate and applied equally to each group
  • Appropriate attention to potential confounding variables

Randomized Controlled Trials and Cohort Studies

Criteria

  • Initial assembly of comparable groups
    • -for RCTs: adequate randomization, including first concealment and whether potential confounders were distributed equally among groups.
    • -for cohort studies: consideration of potential confounders with either restriction or measurement for adjustment in the analysis; consideration of inception cohorts
  • Maintenance of comparable groups (includes attrition, cross-overs, adherence, contamination)
  • Important differential loss to follow-up or overall high loss to follow-up
  • Measurements: equal, reliable, and valid (includes masking of outcome assessment)
  • Clear definition of the interventions
  • All important outcomes considered
  • Analysis: adjustment for potential confounders for cohort stuidies, or intention-to-treat analysis for RCTs

Diagnostic Accuracy Studies

Criteria

  • Screening test relevant, available for primary care, adequately described
  • Study uses a credible reference standard, performed regardless of test results
  • Reference standard interpreted independently of screening test
  • Handles indeterminate result in a reasonable manner
  • Spectrum of patients included in study
  • Sample size
  • Administration of reliable screening test

References

  1. Harris RP, Helfand M, Woolf SH, Lohr KN, Mulrow CD, Teutsch SM. et al. Current methods of the US Preventive Services Task Force: a review of the process. Am J Prev Med. 2001;20(3 Suppl):21–35. [PubMed: 11306229]

Table 4. Systematic evidence reviews used as source documents

References

  1. Compendium of HIV Prevention Interventions with Evidence of Effectiveness. In: Project CsHAPRS. Department of Health and Human Services, editor. 2009.
  2. Albarracin D, McNatt PS, Klein CT, Ho RM, Mitchell AL, Kumkale GT. Persuasive communications to change actions: an analysis of behavioral and cognitive impact in HIV prevention. Health Psychol. 2003;22(2):166–177. [PubMed: 12683737]
  3. Applegate M. AIDS education for adolescents: A review of the literature. 1998.
  4. Ashery RS, Carlson RG, Falck RS, Siegal HA, Wang J. Female condom use among injection drug- and crack cocaine-using women. American Journal of Public Health. 1995;85(5):736–7. [PMC free article: PMC1615417] [PubMed: 7733445]
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* Total of 19 articles representing 13 unique trials for KQ 1 and KQ 2.

Cover of Behavioral Counseling to Prevent Sexually Transmitted Infections
Behavioral Counseling to Prevent Sexually Transmitted Infections [Internet].
Evidence Syntheses, No. 64.
Lin J, Whitlock E, O'Connor E, et al.

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