ArticlePractical laboratory medicine2017
Traditional versus reverse syphilis algorithms: A comparison at a large academic medical center.
Article in Practical laboratory medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed.
- Strengthening STD Screening Programs: Comprehensive Evaluation of High-Throughput Immunoassays for HIV and Syphilis Detection.Microorganisms · 2026Article
- Advances in Syphilis Diagnostics to Address the 21st-Century Epidemic.Clinical chemistry · 2025Review
- Factors associated with false positive results in serological testing for syphilis using EIA among children.Frontiers in pediatrics · 2025Article
- Clinicopathologic assessment of secondary syphilis avoids misdiagnosis: results of comprehensive evaluation of 114 cases.Postepy dermatologii i alergologii · 2024Article
- Article
- Clinical Protocols and Treatment Guidelines for the Management of Maternal and Congenital Syphilis in Brazil and Portugal: Analysis and Comparisons: A Narrative Review.International journal of environmental research and public health · 2022Review
- Comparison of syphilis seropositivity between non-immigrant and immigrant populations in the Anatolian side of Istanbul, Turkiye: Results of five-years retrospective study.Northern clinics of Istanbul · 2022Article
- Not all lytic bone lesions are malignant: A report of syphilitic osteitis presenting with multiple lytic skull lesions.IDCases · 2022Article
- Laboratory Perspective on Racial Disparities in Sexually Transmitted Infections.The journal of applied laboratory medicine · 2021Review
- Article
- Performance of Treponema pallidum recombinant proteins in the serological diagnosis of syphilis.PloS one · 2020Article
- High Agreement of the BioPlex 2200 Syphilis Total & RPR Assay with the Confirmatory Treponemal Test on Weak Positive Screening Samples.Journal of clinical microbiology · 2019Article
- Evaluation of 4 Algorithms to Identify Incident Syphilis Among HIV-Positive Men Who Have Sex With Men Engaged in Primary Care.Sexually transmitted diseases · 2019Article
- Clinical Performance of the BioPlex 2200 Syphilis Total & RPR Assay at a Tertiary Medical Center with a High Rate of Syphilis.Journal of clinical microbiology · 2019Article
- Using Focused Laboratory Management and Quality Improvement Projects to Enhance Resident Training and Foster Scholarship.Academic pathologyArticle
- Advantages and limitations of current diagnostic laboratory approaches in syphilis and congenital syphilis.Expert review of anti-infective therapyReview
- Conventional versus reverse testing algorithm for syphilis in high-risk population: A diagnostic dilemma.Indian journal of sexually transmitted diseases and AIDSArticle
- Traditional versus reverse algorithm for diagnosis of syphilis - An Indian perspective from a national referral laboratory for sexually transmitted infections.Indian journal of sexually transmitted diseases and AIDSArticle
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesAn increasing number of institutions are transitioning from the traditional syphilis testing algorithm (initial screening with nontreponemal tests) to the 'reverse' algorithm (initial screening with treponemal tests such as syphilis IgG). The aim of this study was to evaluate the switch in syphilis algorithm at an academic medical center with a population with low syphilis prevalence. DESIGN AND
methodsWe performed a six-year retrospective study at the University of Iowa Hospitals and Clinics, an academic medical center, comparing the traditional algorithm (n=12,612) with the reverse algorithm (n=10,453). False positives were considered to be positive screens with negative confirmatory testing.
resultsUsing the traditional algorithm, 93 samples (0.7% of total) screened positive with RPR, with 40 of these samples having negative TP-PA testing (43% of positive screens, 0.3% of total). Using the reverse algorithm, 110 screened positive with syphilis IgG (1.1% of total), and 33 of these samples had both negative RPR and TP-PA (30% of positive screens, 0.3% of total). In both algorithms, higher RPR titers and syphilis IgG values were associated with increased probability of positive confirmation.
conclusionsIn this study at an academic medical center, the reverse algorithm had significantly more total positive screens than the traditional algorithm. Both algorithms produced equivalent rates of active infection. The quantitative difference in positives between the two algorithms are the category of patients who are syphilis IgG positive, RPR non-reactive, and TP-PA reactive. Specimens with higher RPR titers and syphilis IgG values are more likely to confirm positive.
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