***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Aims The community-based AERLI intervention provided training and education to people who inject drugs ( PWID ) about HIV and HCV transmission risk reduction , with a focus on drug injecting practice s , other injection-related complications , and access to HIV and HCV testing and care . We hypothesized that in such a population where HCV prevalence is very high and where few know their HCV serostatus , AERLI would lead to increased HCV testing . Methods The national multisite intervention study ANRS-AERLI consisted in assessing the impact of an injection-centered face-to-face educational session offered in volunteer harm reduction ( HR ) centers ( “ with intervention ” ) compared with st and ard HR centers ( “ without intervention ” ) . The study included 271 PWID interviewed on three occasions : enrolment , 6 and 12 months . Participants in the intervention group received at least one face-to-face educational session during the first 6 months . Measurements The primary outcome of this analysis was reporting to have been tested for HCV during the previous 6 months . Statistical analyses used a two-step Heckman approach to account for bias arising from the non-r and omized clustering design . This approach identified factors associated with HCV testing during the previous 6 months . Findings Of the 271 participants , 127 and 144 were enrolled in the control and intervention groups , respectively . Of the latter , 113 received at least one educational session . For the present analysis , we selected 114 and 88 participants eligible for HCV testing in the control and intervention groups , respectively . In the intervention group , 44 % of participants reported having being tested for HCV during the previous 6 months at enrolment and 85 % at 6 months or 12 months . In the control group , these percentages were 51 % at enrolment and 78 % at 12 months . Multivariable analyses showed that participants who received at least one educational session during follow-up were more likely to report HCV testing , compared with those who did not receive any intervention ( 95%[CI ] = 4.13[1.03;16.60 ] ) . Conclusion The educational intervention AERLI had already shown efficiency in reducing HCV at-risk practice s and associated cutaneous complications and also seems to have a positive impact in increasing HCV testing in PWID Background Supporting 21st century health care and the practice of evidence -based medicine ( EBM ) requires ubiquitous access to clinical information and to knowledge-based re sources to answer clinical questions . Many questions go unanswered , however , due to lack of skills in formulating questions , crafting effective search strategies , and accessing data bases to identify best levels of evidence . Methods This r and omized trial was design ed as a pilot study to measure the relevancy of search results using three different interfaces for the PubMed search system . Two of the search interfaces utilized a specific framework called PICO , which was design ed to focus clinical questions and to prompt for publication type or type of question asked . The third interface was the st and ard PubMed interface readily available on the Web . Study subjects were recruited from interns and residents on an inpatient general medicine rotation at an academic medical center in the US . Thirty-one subjects were r and omized to one of the three interfaces , given 3 clinical questions , and asked to search PubMed for a set of relevant articles that would provide an answer for each question . The success of the search results was determined by a precision score , which compared the number of relevant or gold st and ard articles retrieved in a result set to the total number of articles retrieved in that set . Results Participants using the PICO templates ( Protocol A or Protocol B ) had higher precision scores for each question than the participants who used Protocol C , the st and ard PubMed Web interface . ( Question 1 : A = 35 % , B = 28 % , C = 20 % ; Question 2 : A = 5 % , B = 6 % , C = 4 % ; Question 3 : A = 1 % , B = 0 % , C = 0 % ) 95 % confidence intervals were calculated for the precision for each question using a lower boundary of zero . However , the 95 % confidence limits were overlapping , suggesting no statistical difference between the groups . Conclusion Due to the small number of search es for each arm , this pilot study could not demonstrate a statistically significant difference between the search protocol s. However there was a trend towards higher precision that needs to be investigated in a larger study to determine if PICO can improve the relevancy of search results Background Rising rates of infectious diseases in international migrants has reignited the debate around screening . There have been calls to strengthen primary -care-based programmes , focusing on latent TB . We did a cross-sectional study of new migrants to test an innovative one-stop blood test approach to detect multiple infections at one appointment ( HIV , latent tuberculosis , and hepatitis B/C ) on registration with a General Practitioner ( GP ) in primary care . Methods The study was done across two GP practice s attached to hospital Accident and Emergency Departments ( A&E ) in a high migrant area of London for 6 months . Inclusion criteria were foreign-born individuals from a high TB prevalence country ( > 40 cases per 100,000 ) who have lived in the UK ≤ 10 years , and were over 18 years of age . All new migrants who attended a New Patient Health Check were screened for eligibility and offered the blood test . We followed routine care pathways for follow-up . Results There were 1235 new registration s in 6 months . 453 attended their New Patient Health Check , of which 47 ( 10.4 % ) were identified as new migrants ( age 32.11 years [ range 18–72 ] ; 22 different nationalities ; time in UK 2.28 years [ 0–10 ] ) . 36 ( 76.6 % ) participated in the study . The intervention only increased the prevalence of diagnosed latent TB ( 18.18 % [ 95 % CI 6.98 - 35.46 ] ; 181.8 cases per 1000 ) . Ultimately 0 ( 0 % ) of 6 patients with latent TB went on to complete treatment ( 3 did not attend referral ) . No cases of HIV or hepatitis B/C were found . Foreign-born patients were under-represented at these practice s in relation to 2011 Census data ( Chi-square test −0.111 [ 95 % CI −0.125 to −0.097 ] ; p < 0.001 ) . Conclusion The one-stop approach was feasible in this context and acceptability was high . However , the number of presenting migrants was surprisingly low , reflecting the barriers to care that this group face on arrival , and none ultimately received treatment . The ongoing UK debate around immigration checks and charging in primary care for new migrants can only have negative implication s for the promotion of screening in this group . Until GP registration is more actively promoted in new migrants , a better place to test this one-stop approach could be in A&E departments where migrants may present in larger numbers Background : The prevalence of hepatitis C ( HCV ) is elevated within prison population s , yet diagnosis in prisons remains low . Dried blood spot testing ( DBST ) is a simple procedure for the detection of HCV antibodies ; its impact on testing in the prison context is unknown . Methods : We carried out a stepped-wedge cluster-r and omized control trial of DBST for HCV among prisoners within five male prisons and one female prison . Each prison was a separate cluster . The order in which the intervention ( training in use of DBST for HCV testing and logistic support ) was introduced was r and omized across clusters . The outcome measure was the HCV testing rate by prison . Imputation analysis was carried out to account for missing data . Planned and actual intervention times differed in some prisons ; data were thus analysed by intention to treat ( ITT ) and by observed step times . Results : There was insufficient evidence of an effect of the intervention on testing rate using either the ITT intervention time ( OR : 0.84 ; 95 % CI : 0.68–1.03 ; P = 0.088 ) or using the actual intervention time ( OR : 0.86 ; 95 % CI : 0.71–1.06 ; P = 0.153 ) . This was confirmed by the pooled results of five imputed data sets . Conclusions : DBST as a st and -alone intervention was insufficient to increase HCV diagnosis within the UK prison setting . Factors such as staff training and allocation of staff time for regular clinics are key to improving service delivery . We demonstrate that prisons can conduct rigorous studies of new interventions , but data collection can be problematic . Trial registration : International St and ard R and omized Controlled Trial Number Register ( IS RCT N number IS RCT N05628482 ) INTRODUCTION Because of its lack of clinical signs , the detection of hepatitis C virus ( HCV ) infection in the Netherl and s remains suboptimal . Therefore , the Dutch Health Council proposed an HCV campaign aim ed to inform the general public and motivate people at risk to seek medical advice . Because knowledge and awareness of HCV infection is low among primary care workers , the implementation of a support programme for primary care complementary to a HCV campaign seems appropriate . OBJECTIVE To evaluate the added value of a support programme for primary care complementary to a public HCV campaign . METHODS We performed a non-r and omized controlled intervention study . In two similar regions , a public HCV campaign was organized . In the intervention region , an additional support for primary care was provided by means of brochures , short courses and informative visits . RESULTS In the intervention region , the proportional increase in anti-HCV tests was 3.02 ( 57 - 172 tests ) . In the control region , this increase was 1.36 ( 86 - 118 tests ) . In the intervention region , the increase in positive anti-HCV tests was 1.7 % ( 95 % confidence interval ( CI ) : -0.2 % to -3.7 % ) . In the control region , this number decreased by 0.9 % ( 95 % CI : -4.1 % to 2.3 % ) . CONCLUSIONS The addition of primary care practice support leads to considerable improvements in medical consciousness regarding HCV infection in primary care . Even though the positive effect on case finding can not be indisputably demonstrated due to low prevalence , our results indicate such a positive effect . Therefore , future campaigns aim ed at hepatitis C should invariably implement additional support for primary care to improve diagnostic uptake and optimize case finding Objectives To assess the impact of computer-assisted interview compared with pen and paper on disclosure of sexual behaviour , diagnostic testing by clinicians , infections diagnosed and referral for counselling . Methods Two-centre parallel three-arm r and omised controlled open trial . Computer-generated r and omisation with allocation concealment using sealed envelopes . Setting Two London teaching hospital sexual health clinics . Participants 2351 clinic attenders over the age of 16 years . Interventions Computer-assisted self-interview ( CASI ) . Computer-assisted personal interview ( CAPI ) . Pen and paper interview ( PAPI ) . Main Outcome Measures Diagnostic tests ordered , sexually transmitted infections ( STI ) . Secondary Outcomes Disclosure of sexual risk , referral for counselling . Results 801 , 763 and 787 patients r and omly allocated to receive CASI , CAPI and PAPI . 795 , 744 and 779 were available for intention-to-treat analysis . Significantly more diagnostic testing for hepatitis B and C and rectal sample s in the CAPI arm ( odds for more testing relative to PAPI 1.32 ; 95 % CI 1.09 to 1.59 ) . This pattern was not seen among CASI patients . HIV testing was significantly lower among CASI patients ( odds for less testing relative to PAPI 0.73 ; 95 % CI 0.59 to 0.90 ) . STI diagnoses were not significantly different by trial arm . A summary measure of seven prespecified sensitive behaviours found greater reporting with CASI ( OR 1.4 ; 95 % CI 1.2 to 1.6 ) and CAPI ( OR 1.4 ; 95 % CI 1.2 to 1.7 ) compared with PAPI . Conclusion CASI and CAPI can generate greater recording of risky behaviour than traditional PAPI . Increased disclosure did not increase STI diagnoses . Safeguards may be needed to ensure that clinicians are prompted to act upon disclosures made during self-interview . Trial registration IS RCT N : 97674664 In this r and omized-control trial , conducted at a free clinic in France for predominately immigrant population s without healthcare , we demonstrate that simultaneous HIV/HBV/HCV point-of-care rapid testing improves screening outcomes . Increased awareness of infection status likely helped link these patients to care BACKGROUND Direct-acting antiviral therapy ( DAAs ) for hepatitis C infection ( HCV ) have a much smaller burden of treatment than interferon-based regimes , require less monitoring and are very effective . New pathways are required to increase access to treatment amongst people prescribed opioid substitution therapy ( OST ) . METHODS An exploratory cluster r and omised controlled trial with mixed methods evaluation was undertaken to compare the uptake of  dried blood spot testing ( DBST ) and treatment of people with genotype 1 HCV infection in a conventional service pathway versus a pharmacist-led pathway in a population receiving OST . RESULTS Pharmacies r and omised to the conventional pathway obtained 58 DBST from 244 patients (24%):15 new reactive tests and 33 new negative tests were identified . Within the pharmacist-led pathway , 94 DBST were obtained from 262 patients ( 36 % ) : 26 new reactive tests and 54 new negative tests were identified . Participants in the pharmacist-led pathway were more likely to take a DBST ( p<0.003 ) . Of participants referred for treatment through the conventional pathway , 4 patients from 15 with new reactive tests ( 27 % ) attended clinic for assessment 
    Output:
    
Testing targeted to population s at higher risk yielded high coverage rates in many setting s. Implementation of novel testing approaches , including dried blood spot ( DBS ) testing , was associated with increased coverage in several setting s including drug services , pharmacies and STI clinics .
Community‐based testing services were effective in reaching population s at higher risk for infection , vulnerable and hard‐to‐reach population s. In conclusion , our review identified several successful testing approaches implemented in healthcare and community setting s , including testing approaches targeting groups at higher risk , community‐based testing services and DBS testing .
Combining a diverse set of testing opportunities within national testing strategies may lead to higher impact both in terms of testing coverage and in terms of reduction , on the undiagnosed fraction