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. 2011 Jun;18(6):1038-40.
doi: 10.1128/CVI.05066-11. Epub 2011 Apr 20.

Identification of false-positive syphilis antibody results using a semiquantitative algorithm

Belinda Yen-Lieberman  1 , Juliet Daniel, Cathy Means, Joan Waletzky, Thomas M Daly
Affiliations

Identification of false-positive syphilis antibody results using a semiquantitative algorithm

Belinda Yen-Lieberman et al. Clin Vaccine Immunol. 2011 Jun.

Abstract

Screening patients for syphilis serology using a "treponemal assay-first" approach presents unique challenges, particularly when applied to low-prevalence populations. The use of a screening algorithm that incorporates semiquantitative values from treponemal antibody test results can help to identify potential false-positive results while requiring a minimum of repeat testing.

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Figures

Fig. 1.
Fig. 1.
Comparison of treponemal antibody results. A total of 142 samples were tested for treponemal antibodies by the use of both the Bioplex and Trep-Sure (EIA) assays as well as for RPR reactivity. Results are categorized by the SYPHG value detected in the initial Bioplex screening assay.
Fig. 2.
Fig. 2.
ROC analysis of SYPHG values for predicting true-positive (EIA-confirmed) samples. Sensitivity was defined as the identification of samples with reactive results in the confirmatory EIA. The value for the area under the curve (AUC) is 0.919 (95% CI, 0.87 to 0.96), with 100% specificity achieved at all AI values ≥ 5.8. A 2-by-2 contingency table constructed using 6.0 AI as the cutoff is also shown. The frequencies of EIA-confirmed results for the two groups were significantly different (P < 0.0001 [Fisher's exact test]).
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