Associations Between Patient Language Preference and Hepatitis C Screening: Results From the DETECT Hep C Emergency Department Screening Trial
Abstract
Study objective: Hepatitis C virus (HCV) is the most common blood-borne infection in the United States, hence, emergency department (ED)-based HCV screening is effective for diagnosing HCV as an important step leading to referral for treatment. A patient's preferred language other than English (PLOE) may negatively affect overall care, although no prior research has evaluated the effect of language preference on HCV screening in EDs. Thus, the goal of this study was to estimate associations between language preference and HCV testing offer and acceptance as part of routine HCV screening in the ED.
Methods: We performed a secondary analysis of data from the DETECT Hep C Screening Trial, a 3-center, pragmatic randomized clinical trial comparing effectiveness of targeted and nontargeted HCV screening in EDs. To estimate associations between PLOE (versus English) and HCV test offer and acceptance (primary outcomes) while adjusting for potential confounders, risk ratios (RRs) with 95% confidence intervals (CIs) were estimated using multivariable modified Poisson regression. Secondary outcomes included HCV test completion and HCV test antibody and RNA test results.
Results: A total of 147,498 patients were randomly assigned (median age: 41 years; interquartile range [IQR]: 29-57; 51.5% male, 42.3% Black, Non-Hispanic; 20.9% Hispanic; 32.2% White, Non-Hispanic; 10.3% PLOE). We observed significant heterogeneity in patient characteristics, outcomes, and estimates across sites. In…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 147,498 participants or records.
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