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Real Time RT-PCR

Real Time RT-PCR

Real-time reverse transcription-polymerase chain reaction, or Real-time RT-PCR, is an analytical tool used to determine the expression level of target genes. The method involves converting mRNA to complementary DNA with the help of an enzyme known as reverse transcriptase, followed by the PCR amplification of the cDNA. These two processes can be performed simultaneously in a single tube or separately as a two-step reaction.
The real-time quantification of the number of amplified products is...

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Updated: Sep 12, 2025

An Affordable HIV-1 Drug Resistance Monitoring Method for Resource Limited Settings

An Affordable HIV-1 Drug Resistance Monitoring Method for Resource Limited Settings

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Cost Effectiveness of the Reverse Sequence Algorithm Compared With the Traditional Algorithm for Syphilis Screening

Enrique M Saldarriaga¹, Emily D Pollock, David A Jackson

¹National Center for HIV, Viral Hepatitis, STD, and Tuberculosis Prevention, and the Center for Forecasting and Outbreak Analytics, Centers for Disease Control and Prevention, Atlanta, Georgia.

Obstetrics and Gynecology

|August 7, 2025

Summary

This summary is machine-generated.

The reverse sequence syphilis screening algorithm is not cost-effective compared to the traditional method, despite detecting more cases. Overtreatment costs outweigh potential laboratory savings, making it less favorable for public health screening.

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Area of Science:

Medical Diagnostics
Public Health
Health Economics

Background:

Traditional syphilis screening uses a nontreponemal assay followed by treponemal testing.
The reverse sequence algorithm alters this order and adds a second treponemal test for discordant results.
Operational advantages of the reverse sequence necessitate cost-effectiveness evaluation.

Purpose of the Study:

To conduct a cost-effectiveness analysis comparing the reverse sequence and traditional syphilis screening algorithms.
To evaluate the economic impact of each algorithm from a healthcare sector perspective.
To assess the cost per quality-adjusted life-year (QALY) gained for the reverse sequence algorithm.

Main Methods:

Decision tree modeling for pregnant women in prenatal care, including congenital syphilis outcomes.
Simulation of a 10,000-person cohort screened over one year.
Calculation of incremental cost-effectiveness ratios (ICERs) and sensitivity analyses.

Main Results:

The reverse sequence detected more syphilis cases but led to significant overtreatment.
The ICER for the reverse sequence was $463,735/QALY gained, indicating poor cost-effectiveness.
Syphilis prevalence critically influences ICERs, requiring >6% prevalence for favorable cost-effectiveness.

Conclusions:

Under typical conditions, the reverse sequence algorithm is not cost-effective compared to the traditional approach.
Increased overtreatment costs negate potential laboratory savings from treponemal test automation.
The traditional syphilis screening algorithm remains the more economically viable option.