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Self-obtained vaginal swabs are not inferior to provider-performed endocervical sampling for Emergency Department diagnosis of Neisseria gonorrhoeae and Chlamydia trachomatis

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Abstract

-Neisseria gonorrhaeae (NG) and Chlamydia trachomatis (CT) are the two most common sexually transmitted infections (STIs) in the United States and increasing steadily with over 500,000 and 1.7 million cases in 2018, respectively.

-Standard of care for NG/CT diagnosis is testing with a nucleic acid amplification test (NAAT) and sample collection via provider-performed endocervical sampling (PPES).

-PPES can add significant delay in a busy emergency department (ED) setting in which exam room and/or provider availability is limited.

-Prior research in non-emergency department settings on self-obtained vaginal swabs (SOVS), where the patient collects their own vaginal sample using the NAAT swab, has shown favorable results. However, another study has shown a patient preference for PPES over VSS.

-If VSS was found to have noninferior sensitivity compared to PPES in the ED, with good patient acceptability, this would allow for earlier collection of samples and another diagnostic option for patients where a pelvic exam cannot be performed.

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