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PubMed2006

Informed decision making and prostate specific antigen (PSA) testing for prostate cancer: a randomised controlled trial exploring the impact of a brief patient decision aid on men's knowledge, attitudes and intention to be tested.

OBJECTIVE: To examine the impact of a brief patient decision aid (pDA) on men's knowledge, attitudes and intention to have a prostate specific antigen (PSA) test. To explore the important predictors of intention to be tested in men who received the brief pDA. METHODS: A brief pDA designed to facilitate informed decision-making for men considering PSA testing was developed for the NHS Prostate Cancer Risk Management Programme. Men aged 40-75 years selected from 11 General Practices in England and Wales were randomised to receive either a mailed copy of the brief pDA and a questionnaire (intervention group), or a questionnaire alone (control group). The questionnaire assessed knowledge, attitudes, perceived risk and intention to have a PSA test and, for the intervention group, their perceptions of the brief pDA. RESULTS: Nine hundred and ninety of the men who were eligible for the study returned completed questionnaires (response rate=54%). Men who received the brief pDA had significantly higher knowledge scores (p<0.0001) and less positive attitudes (p<0.0001) regarding PSA testing than men in the control group. There was no significant difference between the two groups in intention to be tested within the next 12 months. 87% of men found the brief pDA was easy to read, 94% considered it contained about the right amount of detail and 94% felt the information was presented in a balanced way. Multivariate analysis identified perceived risk (p<0.0001), perceived benefits of PSA testing (p<0.0001), knowledge (p=0.004), attitude (p=0.007) and age (p=0.01) as the most important independent predictors of intention to be tested amongst men in the intervention group. CONCLUSION: The brief pDA was shown to dramatically increase men's knowledge of the benefits and risks of the PSA test. Men who received the brief pDA were significantly less positive about the PSA test, although there was no difference between the two groups regarding their intention to be tested within the next year. PRACTICE IMPLICATIONS: This brief pDA could serve as an acceptable and low cost adjunct to counselling by the General Practitioner (GP), and should promote informed decision making regarding the PSA test. Further research is required to ascertain the utility of the decision aid during the consultation.

Adult↗

PubMed2002

Relative sensitivity of one freshwater and two marine acute toxicity tests as determined by testing 30 offshore E & P chemicals.

Acute toxicity of 30 offshore E & P (Exploration and Production) chemicals was measured using the three standard test organisms Daphnia magna (freshwater cladoceran), Acartia tonsa (marine copepod) and Skeletonema costatum (marine diatom alga). Test chemicals included 20 water-soluble and 10 (partially) non-soluble products. For 22 out of the 30 chemicals, the difference in sensitivity between the three tests varied within one order of magnitude. A very good correlation was found between the two marine tests (r = 0.96, P < 0.01, n = 30), and a correlation coefficient of r = 0.78 (P < 0.01, n = 30) was found between D. magna and both A. tonsa and S. costatum, individually. When the comparison of D. magna and A. tonsa sensitivity was based only on the water-soluble chemicals, a significantly higher correlation was obtained (r = 0.84, n = 20), indicating that the sample preparation method used for the (partially) non-soluble chemicals (the water accommodated fraction (WAF) method) induces additional variation between tests performed with different test media. (Partially) non-soluble chemicals are characterised by phase separation or precipitation at the concentrations used for testing. In a WAF-based test, each test concentration/exposure level is prepared separately, and following mixing and separation, only the water phase is used for testing. Toxicity is related to the amount of substance originally added to the mixing vessels. For 25 of the 30 chemicals, D. magna was found to be less sensitive than the marine copepod by a factor >2. The generally higher sensitivity of the marine toxicity tests compared to the Daphnia test emphasise the importance of using marine data for environmental hazard classification as well as for environmental risk assessment purposes.

Animals↗

PubMed2003

Adaptive test for testing the difference in survival distributions.

An adaptive test is proposed for the problem of testing the difference in survival distributions when the shape of the hazard ratio is unknown, hence the efficient test is unknown. The proposed adaptive test selects a test statistic from a finite set of the weighted logrank statistics T on the basis of the estimates of the efficiencies of the tests in T for given data. The efficiency estimator uses the length of the test based nonparametric confidence interval for the shift in a time transformed shift model. The suggested adaptive test is shown to be asymptotically efficient among the tests in T under the time transformed shift model and conditions commonly used in survival analysis. Simulations demonstrate that the adaptive test enjoys good small sample properties and in most situations is more powerful than the test using the maximum of the tests in T.

Computer Simulation↗

PubMed2003

European multicentre validation trial of two new non-invasive tests for the detection of Helicobacter pylori antibodies: urine-based ELISA and rapid urine test.

AIM: Non-invasive tests for the assessment of Helicobacter pylori status are now an integral part of the management strategies for patients with dyspepsia. The aim of this study was to evaluate a urine based antibody ELISA and a near patient urine test for the diagnosis of H. pylori infection in a European population. METHODS: Urine samples were collected from 449 patients (240 females, 209 males, mean age 54 years), with dyspeptic symptoms but no previous H. pylori eradication therapy, at five centres in four European countries. All patients underwent GI endoscopy and biopsies were taken for H. pylori diagnosis. Urine samples were analysed using an IgG ELISA (URINELISA) and a near patient urine test (RAPIRUN). In addition, a serum IgG ELISA (Pyloriset-EIA-GIII), a whole blood test (Pyloriset-Screen) and a 13C-urea breath test were performed. RESULTS: The sensitivity of the urine based ELISA and the near patient urine test was 90% and 82%, and the specificity 68% and 83%, respectively. The accuracy of the serum ELISA and the whole blood test was comparable with the urine based test. CONCLUSION: The urine based ELISA and the near patient urine test are just as accurate as the serological tests. This comparable accuracy and complete non-invasiveness of the former gives it an advantage over blood based tests. This limits the application of these tests in general practice.

Antibodies, Bacterial↗

PubMed1994

Laboratory diagnosis of heparin-associated thrombocytopenia and comparison of platelet aggregation test, heparin-induced platelet activation test, and platelet factor 4/heparin enzyme-linked immunosorbent assay.

BACKGROUND: As clinical diagnosis of heparin-associated thrombocytopenia (HAT) is often difficult, confirmation by sensitive laboratory assays is desirable. STUDY DESIGN AND METHODS: The sensitivity of the heparin-induced platelet activation (HIPA) test and the platelet aggregation test (PAT) was prospectively compared by using the sera of 209 patients with the putative diagnosis of HAT. Both assays were performed concomitantly with platelets of the same four donors using a different combination of donors from day to day. Further, all sera were assessed with a platelet factor 4 (PF4)/heparin enzyme-linked immunosorbent assay (ELISA). RESULTS: Positive results were obtained with 33 percent of sera in the PF4/heparin ELISA, with 33.5 percent of sera in the HIPA test, and with 11.5 percent of sera in the PAT. The PF4/heparin ELISA and the HIPA test showed no difference in sensitivity (p = 0.27 by McNemar's test) and were more sensitive than PAT (p < 10(-8) by McNemar's test). However, they recognized different patient cohorts. Nine HIPA-indeterminate and 12 HIPA-negative sera were positive in the PF4/heparin ELISA. Eight of the nine indeterminate sera caused platelet activation with high heparin concentrations in the HIPA test. Eleven of the 12 negative sera contained no IgG, but 9 contained IgM and 2 contained IgA HAT antibodies. Four sera that were indeterminate in the PF4/heparin ELISA and 18 sera that were negative were positive in the HIPA test. None of the sera that were positive in the PAT was missed in the HIPA test, but two of those were negative in the PF4/heparin ELISA. All sera were assessed with four low-molecular-weight heparins and a low-molecular-weight heparinoid in the HIPA test with platelets from the same four donors. Low-molecular-weight heparin caused platelet activation with positive sera in 98 percent of tests, and the heparinoid did so in 10 percent; in a further 12.8 percent, crossreactivity to the low-molecular-weight heparinoid could not be excluded. CONCLUSION: The majority of HAT antibodies react with a PF4/heparin complex, but there is strong evidence that other antigens are involved in some patients. The HIPA test and the PF4/heparin ELISA are sensitive for diagnosing HAT, and they complement one another.

Enzyme-Linked Immunosorbent Assay↗

PubMed2001

Test-retest reproducibility and inter-rater reliability of a motor skill test battery for adults.

The purpose of this study was to evaluate the test-retest and inter-rater reliability of nine selected tests for the following basic motor skills: balance, orientation, sense of rhythm, kinaesthetic precision and flexibility. Twenty-five healthy, non-sporting volunteers (14 men, 11 women, aged 36-72 years) were tested in three sessions at one-week intervals by two raters. For the tests of balance on a bar, tandem walking backwards and forwards and ball bouncing, the within-participant and between-session repeatability, as assessed by the intraclass correlation coefficient (ICC), was high (ICC 0.83-0.96), and for the rhythm test it was fair (ICC 0.70). The inter-rater reliability was also high for all the tests (ICC 0.88-0.96) except that for rhythm (ICC 0.76). In a test-retest design, these tests were sensitive enough to produce sufficient variation between participants in terms of differentiating between individuals. The learning effect was the most remarkable between the pretest and test sessions, and the reliability was better for the test-retest session although a statistically significant difference existed only for tandem walking forwards (p<0.02) and balance on a bar (p<0.004). The tests with quantitative scores had a smaller margin of error than those with qualitative scores. These tests provide reliable alternatives for assessing basic motor skills of non-sporting adults in the context of physical activity promotion.

Adult↗

PubMed1983

[Comparison between the intravenous TRH-test and the T4-thyroid suppression test for the diagnosis of borderline hyperthyroidism].

In a prospective study of 60 patients with T3 and/or T4 values within +/- 10% of the upper limit of normal, the suppressibility of thyroid storage values before and after oral administration of 3 mg L-thyroxine was tested and compared with the results of an intravenous TRH test. In 46 patients the results of the two methods agreed (77%): in 31 patients (52%) radioiodine uptake could not be suppressed nor TSH stimulated in the TRH test. Physiological suppression of the storage values in normal TSH stimulation after TRH as a sign of completely euthyroid function was present in 15 (25%). In the remaining 14 patients, 13 had a suppressed TRH test. In all patients radioiodine uptake could be suppressed either normally (above 50%) or partially (20-30%). A normal T4 suppression test in the absence of TSH rise after TRH indicates that biologically active TSH is circulating, even though not demonstrated by radioimmuno-assay. A normal T4 suppression test is an important argument against treating a given case of hyperthyroidism. The T4 suppression test reveals smooth gradation between euthyroid and hyperthyroid states. If the TRH test is normal one can assume a physiological T4 suppression test and no further tests are needed. If the TRH test is negative and there is only slight elevation of the thyroid hormones, the T4 suppression test is indicated before definitive treatment of hyperthyroidism is initiated.

Adult↗

PubMed1997

HIV antibody testing: Genito-Urinary Clinic or additional site same-day testing service.

It has been suggested that different groups of individuals, possibly those at greater risk, may choose to attend anonymous HIV services not attached to Genito-Urinary Medicine Clinics. This paper reports the results of a comparative study of documented sociodemographic profile and risk category for individuals having HIV antibody tests at a Genito-Urinary Medicine Clinic and at an additional site same-day HIV antibody testing service not attached to a Genito-Urinary Medicine Clinic but within the same hospital. A retrospective case record analysis for 12 months from 1.10.93 to 30.9.94 was performed. During the 12-month study period 954 people had HIV testing at the additional site HIV antibody testing service and 803 had HIV antibody testing at the Genito-Urinary Medicine Clinic. Of those attending the additional site testing service 218 (22.9%) were homosexual/bisexual males as compared with 128 (15.9%) of the Genito-Urinary Medicine Clinic attendees (p < 0.01). A total of 22 (2.3%) of the individuals attending the additional site service gave a history of sexual contact in Africa as compared with 52 (65%) attending the Genito-Urinary Medicine Clinic (p < 0.001). There was no significant difference in the gender or age of those having HIV antibody tests at the two locations (p = 0.82 and p = 0.39 respectively). Four hundred and seventeen (52%) of the tests performed at the Genito-Urinary Medicine Clinic were performed on those who had not already decided to have a test before attending the clinic. Of those individuals who had decided to have a test before attending, 2.5 times as many attended the Same-Day Service as attended the Genito-Urinary Medicine Clinic (954 additional site attenders compared with 384 Genito-Urinary Medicine Clinic attenders). The results suggest that to optimize patient choice and benefit from a HIV antibody testing service this should be available at both Genito-Urinary Medicine Clinics and at additional site testing services.

Adult↗

PubMed1998

Comparison of the clientele of an anonymous HIV test centre and persons tested in the general population.

This study compares the clientele of a Swiss anonymous test centre with the general population tested. Information was obtained through similar questionnaires submitted to two samples of HIV-tested people aged from 17 to 45 years: the first administered in the context of a general population telephone survey (n = 245) and the second completed during face-to-face interviews of the clientele of an anonymous test centre (n = 250). The test centre sample has higher proportions of younger and single people. Attenders for anonymous testing were more likely to have acquired a new regular partner during the year preceding the interview (48.0% versus 14.4%). These differences remain when controlling for age and gender. Decision to test comes mostly from the respondent's own initiative, but suggestion from a doctor is more frequent in the general population (23.8% versus 0.8%), whereas suggestion from partner or friends is more frequent in the anonymous centre (44.4% versus 3.0%). The anonymous test centre clientele is not different from the general population tested except for the relational situation and origin of decision for testing. The test centre has become a place where the general population finds a response to a situation-specific need for HIV testing.

Adolescent↗

PubMed1975

A prospective evaluation of heterophile and Epstein-Barr virus-specific IgM antibody tests in clinical and subclinical infectious mononucleosis: Specificity and sensitivity of the tests and persistence of antibody.

Three heterophile antibody tests and a test specific for IgM antibody to Epstein-Barr virus were evaluated during prospective studies of infectious mononucleosis. Specificity was judged by the frequency of false-positive results in sera of known qualities taken before illness; except for two patients bled during early, unrecognized illnes,, titers of greater than or equal to 1:40 were detected in 12% by the absorbed sheep red cell test, in 6.7% by the absorbed horse red cell test, and in none by the beef cell hemolysin test. None had IgM antibody specific for Epstein-Barr virus in sera obtained before illness. In addition, no rises in titer of heterophile antibody were detected by the horse cell test in 38 patients with proved rubella and/or influenza infection. In terms of sensitivity (indicated by the percentage of cases with diagnostic titers during infectious mononucleosis), 97% were positive by the Epstein-Barr virus IgM test, 96% by the horse cell agglutination test, 85% by the beef hemolysin test, and 81% by the sheep cell agglutination test. Persistence of antibody was judged by serial bleedings up to three years after illness; titers of heterophile antibody by the sheep agglutination and beef hemolysin tests as well as titers of IgM antibody to Epstein-Barr virus returned to normal in two to three months, whereas the horse cell heterophile test remained positive for a year or more in 75%. Inapparent and mild infections with Epstein-Barr virus resulted in the production of horse cell heterophile antibody in 48.4% of 122 subjects.

Antibodies, Heterophile↗

PubMed2000

Regional differences in HIV testing among European patients with sexually transmitted diseases: trends in the history of HIV testing and knowledge of current serostatus.

OBJECTIVES: To determine trends in (1) HIV testing and knowledge of current serostatus and (2) clinic-visits of aware HIV-infected patients and (3) to determine associates of incident HIV infection among patients with sexually transmitted disease (STD) in 15 countries participating in a European Community anonymous HIV seroprevalence survey. METHODS: Demographics, STD diagnosis, self-reported history of HIV tests and current HIV test results were collected for patients diagnosed with one of 12 pre-selected STDs. Incident HIV infections were determined among patients who reported prior HIV-negative test results. RESULTS: Between June 1990 and December 1996, 66560 STD patients were tested for HIV. Of these, 1581 (2.4%) reported a prior HIV-positive test. Of 41727 (62%) patients who reported no previous HIV test, 611 (1.4%) were HIV infected. Of 20785 (31%) patients who reported a prior HIV-negative test, 213 (1.0%) were HIV infected. Of 2467 (4%) patients without prior HIV test data available 123 (4.9%) were HIV infected. Overall, 63% of HIV-seropositive patients was aware of their HIV infection. Over time, the proportion of aware HIV-seropositive patients increased in some exposure categories in south and central Europe. Among the 11684 patients who reported dates of prior HIV-negative tests, 108 HIV infections were found. Compared with the north, HIV incidence was higher in the central region [odds ratio (OR), 1.23; 95% confidence interval (CI), 0.71-2.12] and in the south (OR, 4,39; 95% CI, 2.80-6.88) in all exposure categories except homosexual men. CONCLUSIONS: Two-thirds of patients with an STD had never been tested for HIV. Of all HIV infections found, 32% were undiagnosed, indicating missed opportunities for counselling, safe sex education and referral for treatment. HIV testing should be routinely offered to all STD patients.

AIDS Serodiagnosis↗

PubMed2004

Bayesian sample size determination for prevalence and diagnostic test studies in the absence of a gold standard test.

Planning studies involving diagnostic tests is complicated by the fact that virtually no test provides perfectly accurate results. The misclassification induced by imperfect sensitivities and specificities of diagnostic tests must be taken into account, whether the primary goal of the study is to estimate the prevalence of a disease in a population or to investigate the properties of a new diagnostic test. Previous work on sample size requirements for estimating the prevalence of disease in the case of a single imperfect test showed very large discrepancies in size when compared to methods that assume a perfect test. In this article we extend these methods to include two conditionally independent imperfect tests, and apply several different criteria for Bayesian sample size determination to the design of such studies. We consider both disease prevalence studies and studies designed to estimate the sensitivity and specificity of diagnostic tests. As the problem is typically nonidentifiable, we investigate the limits on the accuracy of parameter estimation as the sample size approaches infinity. Through two examples from infectious diseases, we illustrate the changes in sample sizes that arise when two tests are applied to individuals in a study rather than a single test. Although smaller sample sizes are often found in the two-test situation, they can still be prohibitively large unless accurate information is available about the sensitivities and specificities of the tests being used.

Bayes Theorem↗

PubMed1975

The experimenter effect on results with oral form recognition tests and with tests measuring oral muscular ability.

In the introductory part of the present study considerable differences in registrations were found between three different experimenters when an oral form recognition test and an oral muscular-motor test was applied on ten subjects. In the following part recording differences between six other experimenters were evaluated. An intensive training programme was established and repeated twice with those six experimenters during a test period which twenty-eight subjects were tested with the same tests as mentioned above. The results show that in spite of the training programme, uniformity could not be obtained between experimenters. Registration deviations were (1) clearly found for the time results of identifying, (2) less distinctly for registration of subjective judgements of difficulty or for the times of putting together the halves of the test pieces in the test of muscular-motor ability and (3) not at all at the recording of test peice confusions at the oral form recognition test. It was found that the present forms of the training programme alone were not sufficient to gain uniformity between different experimenters but the suitability of prospective experimenters who are supposed to form a common group should be tested by an evaluation of test results found in a real test situation. Experimenters who are clearly deviating, should be replaced by other ones for the task who are more suitable inidividuals. The present study thus emphasizes the previously observed difficulties when clinical observations made by different persons are to be compared.

Adult↗

PubMed1996

Ethanol resistive microbubble test: a modification of the stable microbubble test used to predict respiratory distress syndrome.

The stable microbubble (SM) test on gastric aspirate obtained at birth proved useful in identifying infants who would develop respiratory distress syndrome (RDS). This test involves only the count of stable microbubbles of < or = 15 microns in diameter. Larger bubbles (> 15 microns in diameter) are not necessary for the test and may interfere with stable microbubble counting. The aims of the present study were to determine: (i) if larger bubbles could be selectively removed by adding ethanol, a potent bubble breaker; and (ii) if the predictive value of this modified test, the ethanol resistive microbubble (ERM) test, on the development of RDS was similar to that of the SM test. Varying amounts of different concentrations of ethanol-water solutions were added to the top of the bubble crop generated by the SM test procedure, and the mean counts of stable microbubbles and larger bubbles in five regions were calculated. A volume of 10 microL of 47.5% ethanol was effective in defoaming larger bubbles generated by the SM test procedure without altering the stable microbubble counts. When concurrently performed on 43 samples of gastric aspirate obtained at birth from infants of less than 35 weeks gestation, the RDS predictive value of the ERM test was similar to that of the SM test. It was concluded that the ERM test may serve as an alternative to the SM test.

Amniotic Fluid↗

PubMed1998

The effect of test duration on the sensitivity and specificity of ultra-rapid urease test for the detection of Helicobacter pylori infection.

BACKGROUND: 'Home made' ultra-rapid urease tests are used extensively in the Asia Pacific region. Data on the reliability of these 'home made' tests are limited. AIMS: To evaluate the effect of test duration on the sensitivity and specificity of a self-prepared biopsy urease test for the detection of Helicobacter pylori. METHODS: Using histology as the 'gold standard', the effect of test duration on the sensitivity and specificity of a self prepared urease test for the detection of H. pylori was evaluated in 411 consecutive patients undergoing upper gastrointestinal endoscopy. RESULTS: Histology was positive for H. pylori in 217 of the 411 patients (52.8%). Within 24 hours of retrieving the specimen, 189 (87.1%) of the histology positives and 174 (89.7%) of the histology negatives were correctly identified by the urease test. Of the H. pylori positives, 72.0%, 81.0%, 89.9% and 100% were detected by the urease test within one minute, five minutes, three hours and 24 hours respectively. Thus, sensitivities of the urease test at one minute, five minutes, three hours and 24 hours were 62.7%, 70.5%, 78.3% and 87.1% respectively. Corresponding figures for the specificity were 93.8%, 93.3%, 92.3% and 89.7% respectively. Using a receiver-operating characteristic curve, an optimal combination of sensitivity and specificity was obtained when the urease test was read at 24 hours. CONCLUSIONS: While the biopsy urease test was positive in most cases within a minute, better results could be obtained if the test continued to be read over a 24 hour period.

Adolescent↗

PubMed2004

Patterns of bone mineral density testing: current guidelines, testing rates, and interventions.

OBJECTIVES: To identify potential obstacles to bone mineral density (BMD) testing, we performed a structured review of current osteoporosis screening guidelines, studies of BMD testing patterns, and interventions to increase BMD testing. DESIGN: We searched medline and HealthSTAR from 1992 through 2002 using appropriate search terms. Two authors examined all retrieved articles, and relevant studies were reviewed with a structured data abstraction form. MEASUREMENTS AND MAIN RESULTS: A total of 235 articles were identified, and 51 met criteria for review: 24 practice guidelines, 22 studies of screening patterns, and 5 interventions designed to increase BMD rates. Of the practice guidelines, almost one half (47%) lacked a formal description of how they were developed, and recommendations for populations to screen varied widely. Screening frequencies among at-risk patients were low, ranging from 1% to 47%. Only eight studies assessed factors associated with BMD testing. Female patient gender, glucocorticoid dose, and rheumatologist care were positively associated with BMD testing; female physicians, rheumatologists, and physicians caring for more postmenopausal patients were more likely to test patients. Five articles described interventions to increase BMD testing rates, but only two tested for statistical significance and no firm conclusions can be drawn. CONCLUSIONS: This systematic review identified several possible contributors to suboptimal BMD testing rates. Osteoporosis screening guidelines lack uniformity in their development and content. While some patient and physician characteristics were found to be associated with BMD testing, few articles carefully assessed correlates of testing. Almost no interventions to improve BMD testing to screen for osteoporosis have been rigorously evaluated.

Bone Density↗

PubMed1998

Prospective comparison of rapid urease tests (PyloriTek, CLO test) for the diagnosis of Helicobacter pylori infection in symptomatic children: a pediatric multicenter study.

OBJECTIVE: Rapid urease tests are reliable methods to diagnose Helicobacter pylori (HP) infection in the endoscopy suite. The PyloriTek test kit is a new rapid urease test that has the advantage of a 1-h final reading. The aim of this study was to compare the accuracy of PyloriTek and the test in the diagnosis of H. pylori infection in children. METHODS: Children from four different pediatric gastroenterology centers were recruited prospectively into the study. These children were >5 yr old and had an upper endoscopy procedure. Antral biopsies were examined for both rapid urease tests in the endoscopy suite, and others were sent for routine histological examination. RESULTS: A total of 242 children were recruited into the study over approximately 1 yr. The concordance between PyloriTek and CLO test was 98% (238 of 242). Twenty-five children were positive for HP organisms by PyloriTek and CLO test, whereas four children were positive by PyloriTek but negative by CLO test. PyloriTek was comparable to CLO test for the diagnosis of HP organisms and HP-associated gastritis. Moreover, in 48% of the positive results, PyloriTek gave significantly faster results than CLO test. CONCLUSIONS: We conclude that PyloriTek is an appropriate rapid urease test to use in children and may have an advantage over the CLO test because of its shorter reading time.

Biopsy↗

PubMed1982

Unheated serum reagin test as a quantitative test for syphilis.

The unheated serum reagin (USR) test, a standard qualitative test for syphilis, was evaluated for use as a quantitative test for the serodiagnosis of syphilis and as a means of determining the effectiveness of treatment. Tests were performed on 664 syphilitic sera from treated and untreated patients in the primary, secondary, and latent stages of the disease. Also included were 95 false-positive sera and 36 sera from presumably normal donors. The Venereal Disease Research Laboratory slide and rapid plasma reagin 18-mm circle card tests were used as a basis for comparison with the USR test. Results of the USR quantitative test paralleled the Venereal Disease Research Laboratory and rapid plasma reagin card quantitative tests with approximately 84% agreement. The advantages of the USR test make the findings of this study significant in that: (i) less technical manipulation is required to perform the USR test than the Venereal Disease Research Laboratory slide test; (ii) no labor cost is incurred for daily Venereal Disease Research Laboratory antigen preparation; and (iii) the USR antigen is less expensive than the rapid plasma reagin card tests antigen.

Antibodies↗