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Home : Infectious Diseases : Sexual Health & STI : Early release of chapters from the Canadian Guidelines on STI 2006 Edition

Early release of chapters from the Canadian Guidelines on Sexually Transmitted Infections 2006 Edition

This posting is an early release of chapters from the Canadian Guidelines on Sexually Transmitted Infections 2006 Edition. As the Canadian Guidelines have not been finalized for publication this posting may not exactly reflect the chapters which will appear in the final print version.

Under the coordination of the Sexual Health and Sexually Transmitted Infections (STI) Section, Public Health Agency of Canada (PHAC), an Expert Working Group (EWG) on STI with members from across Canada have voluntarily participated as authors and reviewers to update the 1998 Canadian STD Guidelines. Each updated chapter underwent a minimum of four rounds of blinded expert review, three within the EWG and one with at least two external reviewers. The new Canadian Guidelines on Sexually Transmitted Infections 2006 Edition are scheduled to be published in the fall of 2006, and will provide evidence-based recommendations for the prevention, diagnosis, treatment and management of STIs in Canada.

Guidelines presented in this document reflect the views of the Expert Working Group on Canadian Guidelines for Sexually Transmitted Infections. They should be construed not as rules but rather as recommendations.

The EWG and PHAC acknowledge that the advice and recommendations set out in this statement are based upon the best current available scientific knowledge and medical practices, and they are disseminating this document to clinical and public health professionals for information purposes. Persons administering or using drugs, vaccines or other products should also be aware of the contents of the individual product monograph(s) for those products, or other similarly approved standards or instructions for use provided by the licensed manufacturer(s). Recommendations for use and other information set out in these guidelines may differ from that set out in product monograph(s) or other similarly approved standards or instructions for use. Manufacturers have sought approval and provided evidence as to the safety and efficacy of their products only when used in accordance with the product monograph(s) or other similarly approved standards or instructions for use.

Level of recommendation and quality of evidence indicators have been included for the treatment recommendations of the Canadian Guidelines on Sexually Transmitted Infections 2006 Edition. The indicators used reflect a combination of the methodologies from the U.S. Preventive Services Task Force and the Canadian Task Force on Preventive Health Care and have been modified and simplified for use in these guidelines as outlined in Tables 1 and 2.

Table 1. Levels of recommendation

Recommendation: A Strongly recommends that clinicians routinely provide the treatment to eligible patients. Good evidence that the treatment improves important health outcomes and concludes that benefits substantially outweigh harms
Recommendation: B Recommends that clinicians routinely provide the treatment to eligible patients. At least fair evidence that the treatment improves important health outcomes and concludes that benefits outweigh harms
Recommendation: C No recommendation for or against routine provision of the treatment. At least fair evidence that the treatment can improve health outcomes but concludes that the balance of the benefits and harms is too close to justify a general recommendation
Recommendation: D Recommends against routinely providing the treatment to asymptomatic patients. At least fair evidence that the treatment is ineffective or that harms outweigh benefits
Recommendation: I E vidence is insufficient to recommend for or against routinely providing the treatment. Evidence that the treatment is effective is lacking, of poor quality or conflicting, and the balance of benefits and harms cannot be determined

Note: Modified from
Harris RP, Hefland M, Woolf SH, 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

Table 2. Quality of evidence

I Evidence from at least one properly randomized, controlled trial
II Evidence from at least one well-designed clinical trial without randomization, from cohort or case-control analytic studies (preferably from more than one centre), from multiple time-series studies or from dramatic results in uncontrolled experiments
III Evidence from opinions of respected authorities based on clinical experience, descriptive studies or reports of expert committees

Note: Modified from :
Harris RP, Hefland M, Woolf SH, 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

Gross PA, Barrett TL, Dellinger EP, et al. Purpose of quality standards for infectious diseases. Infectious Diseases Society of America. CIin Infect Dis 1994;18:42

[Centre for Infectious Disease Prevention and Control]

 
Last Updated: 2006-06-26 Top
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