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Cerebrospinal fluid serology--is its routine use justifiable?
Public Health Reports (Washington, D.C. : 1974)
|May 1, 1977
Summary
Cerebrospinal fluid (CSF) syphilis serology tests are increasingly requested despite low positive results. Most tests were performed without appropriate preliminary testing, indicating a need to review CSF syphilis test utilization.
Area of Science:
- Neurology
- Infectious Diseases
- Clinical Diagnostics
Background:
- Neurosyphilis testing requests have risen despite its rarity.
- Low positive results suggest inappropriate test utilization.
Purpose of the Study:
- To investigate the criteria and appropriateness of cerebrospinal fluid (CSF) syphilis serology test requests.
- To identify patterns in physician ordering practices for CSF syphilis testing.
Main Methods:
- A survey was conducted among physicians who requested CSF syphilis serology tests.
- Physician questionnaires assessed reasons for testing and patient demographics.
- Analysis of available blood serology and patient outcomes.
Main Results:
- Neurosyphilis was not suspected in 63% of 337 sampled patients.
- Over half of patients with specified ages were under 40.
- 63% lacked blood serology reports; only 13% of available reports were reactive.
- Many tests were ordered without preliminary screening, particularly by specialists.
Conclusions:
- CSF syphilis serology tests are frequently performed without adequate justification or preliminary testing.
- Physicians, especially specialists, may be over-utilizing CSF syphilis tests.
- Laboratory directors should lead educational initiatives to improve appropriate test ordering.