Navigation Links
Study shows missed opportunities for HIV diagnosis in emergency departments

CINCINNATINew University of Cincinnati (UC) research on HIV testing at local emergency departments shows that hospitals miss opportunities to diagnose patients who do not know they are infected with HIV, even when a regular testing program is in place.

The study is part of a special supplement to the July issue of Annals of Emergency Medicine, sponsored by the Centers for Disease Control and Prevention (CDC). The supplement includes a series of studies on HIV testing in the nation's emergency departments, finding that while a growing number of emergency departments (EDs) are providing some HIV testing, there are still challenges to widespread expansion of testing as a routine part of emergency care.

UC Assistant Professor of emergency medicine Michael Lyons, MD, was one of four guest editors for the publication.

"HIV testing in is one of the most critical parts of the fight against HIV," says Lyons, lead author on the study. "Previous studies have shown that patients with undiagnosed HIV often visit health care settings, particularly emergency departments, before eventually receiving a diagnosis, but how to capitalize on these opportunities for earlier diagnosis remains unclear. We also do not fully understand how the frequency of missed opportunities differs between different emergency departments."

The study reviewed records for a set of 276 newly diagnosed HIV patients to determine whether the diagnosis might have been made in an earlier ED visit that didn't include an HIV test. Researchers found missed opportunities occurred in 157 visits to an academic emergency department, 24 visits in an urban community hospital and six visits to a suburban community hospital.

"The number of missed opportunities differed between facilities, but all centers had at least some encounters with persons with undiagnosed HIV," says Christopher Lindsell, PhD, co-author and vice chair for research in emergency medicine at UC.

"Many, but not all, encounters included at least one indication for HIV testing. This suggests that only universal screening will identify all undiagnosed patientsbut when that's not feasible, physicians can improve overall detection by testing patients who they recognize as having increased risk of infection. All EDs should be capable of HIV testing in these instances."

A related study by Lindsell, also in the CDC supplement, described a method for hospitals to estimate the number of patients with undiagnosed HIV that visit their ED. "We know that not all EDs see the same number of undiagnosed patients. With this tool, an ED can estimate their need for screening before investing significant resources to increase testing," says Lindsell.

Several other UC studies, led by emergency medicine and infectious diseases researchers, are also included in the supplement, all designed to better understand how to expand HIV testing and prevention in emergency department settings.

"With this research, the academic emergency medicine community is helping to interpret and implement the CDC's recommendations for routine screening in health care settings," says Lyons. "Altogether there has been a lot of progress; there are still many challenges to expanding HIV testing. We're trying to provide a road map to show where and how limited testing resources are best allocated and trying to motivate screening uptake by emergency physicians."

One UC study, led by former emergency medicine resident Nathan Hudepohl, MD, measured the number of patient visits and HIV tests in the UC Health University Hospital ED from 2003 through 2008.

They found that although the HIV testing program provided testing during fewer than 2 percent of ED visits each year, the number of ED patients who had been tested by the program eventually grew to 6.9 percent.

"In just five years of testing, we increased the proportion of ED patients known to have been tested in the program 18 percent," says Lyons.

"Although this falls short of the universal testing advocated by the CDC, our results show that incremental efforts can gradually accumulate impact over time. Even if an ED cannot test as frequently as is recommended, the ED can still work towards screening the population by providing whatever amount of testing is possible."


Contact: Katy Cosse
University of Cincinnati Academic Health Center

Related medicine news :

1. Despite Treatment, Employees with Depression Generate Higher Absentee Costs, According to Thomson Reuters Study
2. American Council on Exercise (ACE) Study Reveals Kettlebells Provide Powerful Workout in Short Amount of Time
3. TV drama can be more persuasive than news program, study finds
4. Study carried out into biological risks of eating reptiles
5. Neuroimaging study may pave way for effective Alzheimers treatments
6. Study finds racial gaps continue in heart disease awareness
7. Luth Researchs IndicatorEDG(TM) Study Finds Americans Hopes of Achieving Their Dreams Are Fading
8. First blinded study of venous insufficiency prevalence in MS shows promising results
9. Soothing infants with food focus of childhood obesity study
10. People with anxiety disorder less able to regulate response to negative emotions, study shows
11. American Heart Association Rapid Access Journal Report: Study Finds Racial Gaps Continue in Heart Disease Awareness, Low Knowledge of Heart Attack Warning Signs Among Women
Post Your Comments:
(Date:10/13/2017)... ... 2017 , ... As health professionals work to improve their approach to healthcare, ... doing more than filling out a survey; in many cases health professionals and patients ... health care and research on the importance of active engagement with patients and members ...
(Date:10/13/2017)... ... October 13, 2017 , ... ... ‘17, and Jennifer Huggins, PharmD ’17, along with clinical associate professor Janice ... of cardiovascular diseases during the 15th Annual Women’s Health Conference. The SIU ...
(Date:10/13/2017)... ... October 13, 2017 , ... Ellevate Network, the leading network ... advocate for action towards gender equality at their inaugural Summit in New York City ... and reached a social audience of over 3 million. To watch the Mobilize Women ...
(Date:10/13/2017)... ... ... Journey: From the Mountains to the Mission Field”: the story of a missionary couple ... From the Mountains to the Mission Field” is the creation of published author, Carole ... and currently teaches a class of ladies at her church, which she has taught ...
(Date:10/12/2017)... ... October 12, 2017 , ... The company has developed ... consumer and regulatory authorities worldwide. From Children’s to Adults 50+, every formula has ... highest standard. , These products are also: Gluten Free, Non-GMO, Vegan, Soy ...
Breaking Medicine News(10 mins):
(Date:10/12/2017)... Pa. , Oct. 12, 2017 ... leader in innovative solutions for injectable drug administration, today ... before the market opens on Thursday, October 26, 2017, ... the results and business expectations at 9:00 a.m. Eastern ... (U.S.) or 253-336-8738 (International). The conference ID is 94093362. ...
(Date:10/10/2017)... , Oct. 10, 2017  NDS received FDA 510(k) clearance in ... medical-grade battery-powered display stand specifically designed for endoscopy environments. An innovative ... into a clinical solution to support the improvement of patient outcomes, ... Design ... Solution ...
(Date:10/4/2017)... 4, 2017  According to the Centers for Disease Control and Prevention ... . PhysicianOne Urgent Care is helping communities across Massachusetts ... , by offering no-cost* flu shots through the end of the month. ... health insurance regulations. ... to get a flu shot is by the end of October, according ...
Breaking Medicine Technology: