which is the correct answer: Screening for syphilis in women in the early- and l
ID: 3254187 • Letter: W
Question
which is the correct answer:
Screening for syphilis in women in the early- and late-stages of pregnancy may significantly reduce the burden of syphilis to both the mother and child. The most common screening tests are based on serological tests for the detection of antibodies. The following table summarises the sensitivity and specificity of a number of potential screening tests for syphilis*. Please examine the data and answer Questions 1 to 4.
Test
Sensitivity
Specificity
VDRL
78%
98%
RPR card
86%
98%
USR
80%
99%
TP-PA
88%
96%
*Adapted from Ratnam 2005. Can J Infect Dis Med Microbial. 16(1):45-51
Question 1:
Based on the above information, which test would you select for screening if you were interested in ensuring that no cases of syphilis are missed?
a.
VDRL, RPR card and USR are all roughly equivalent
b.
USR
c.
RPR card
d.
TP-PA
e.
VDRL
Test
Sensitivity
Specificity
VDRL
78%
98%
RPR card
86%
98%
USR
80%
99%
TP-PA
88%
96%
Explanation / Answer
What is a Sensitive Test?
The sensitivity of a test (also called the true positive rate) is defined as the proportion of people with the disease who will have a positive result. In other words, a highly sensitive test is one that correctly identifies patients with a disease. A test that is 100% sensitive will identify all patients who have the disease. It’s extremely rare that any clinical test is 100% sensitive. A test with 90% sensitivity will identify 90% of patients who have the disease, but will miss 10% of patients who have the disease.
What is a Specific Test?
The specificity of a test (also called the True Negative Rate) is the proportion of people without the disease who will have a negative result. In other words, the specificity of a test refers to how well a test identifies patients who do not have a disease. A test that has 100% specificity will identify 100% of patients who do not have the disease. A test that is 90% specific will identify 90% of patients who do not have the disease and will miss 10% of patients who do not have the disease.
Question 1 :
Answer :- As, it is given that to select for screening if to be interested in ensuring that no cases of syphilis are missed, then we have to choose a more sensitive test......... which is TP-PA test ..... ie. answer will be the option
d. TP-PA test.
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