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Teens visiting a pediatric emergency department (ED) are more likely to disclose information about their sexual activity when filling out a computerized survey, a new study found. 

This information can be used to determine whether the respondents should be tested for sexually transmitted infections (STIs).

"We wanted to take advantage of newer technology and communication methods to achieve better health outcomes for patients visiting the ED," said Fahd A. Ahmad, MD, a clinical and postdoctoral fellow in pediatric emergency medicine who treats patients at St. Louis Children's Hospital.

Ahmad and his colleagues at Washington University School of Medicine in St. Louis, developed a computerized system to assess risk factors for Chlamydia and N. gonorrhea, which cause STIs, in adolescents. Patients were eligible to fill out the questionnaire even if they were being treated in the ED for reasons unrelated to STIs.

460 patients ages 15-21 years completed the qestionnaire, and the computer software provided a recommendation as to whether the teen should be tested for STIs based on a decision algorithm developed by the researchers. The recommendation and a summary of the patient's answers were integrated in the electronic medical record so that the ED doctors and nurses would have access to the information and could order any needed tests.

"When we implemented the system, we found that almost half of the patients who completed the questionnaire were in need of STI testing, and that was the same whether or not their primary complaint was related to STIs," Ahmad said.

The team also found that the overall rate of Chlamydia and N. gonorrhea testing in adolescents visiting the ED almost doubled — from 8.8 percent to 15.1 percent — after the computerized survey was introduced compared with rates during the previous 15 months. Twenty percent of patients who were tested had an STI and received treatment. However, many of the patients did not receive testing as recommended for a variety of reasons.

It was also found that it took about eight minutes for respondents to fill out the questionnaire. Ninety-one percent said the system was "very easy" or "easy" to use. And 83 percent said they were "very comfortable" or "comfortable" with the system's confidentiality. Finally, 71 percent said they would prefer an electronic survey over an in-person interview or written questionnaire in the future.

Ahmad will present the findings of the study today, at the Pediatric Academic Societies (PAS) annual meeting in Boston.