Abstract:
:Three policies for decreasing unnecessary cerebrospinal fluid (CSF) management Venereal Disease Research Laboratory (VDRL) tests were compared. The first policy attempted to educate physicians about the use of serologic tests for diagnosing neurosyphilis but allowed the CSF VDRL to be performed either as a screening test or as a retrospective test. The second policy required that the CSF VDRL be performed as a retrospective test without regard to the patient's serologic status. The third policy required that a patient be seropositive by either rapid plasma reagin (RPR) or fluorescent treponemal antibody absorbance (FTA-ABS) before a CSF VDRL could be performed. Before these policies were instituted, VDRL testing was performed on 18.2% of all CSF samples. The optional and required retrospective policies decreased the CSF VDRL rate to 13.0% and 8.5%, respectively, but the percentages of seropositive patients for whom these procedures were performed were only 7.3% and 12.9%. The third policy decreased the CSF VDRL test rate to 1.8% (P less than 0.001) with seropositivity improving to 90%. To assure serologic tests are obtained in the evaluation of neurosyphilis, requirement for seropositivity must be implemented with the use of retrospective CSF VDRL testing.
journal_name
Am J Clin Patholjournal_title
American journal of clinical pathologyauthors
Albright RE Jr,Christenson RH,Emlet JL,Graham CB 3rd,Estevez EG,Wilson ML,Reller LB,Schneider KAdoi
10.1093/ajcp/95.3.397subject
Has Abstractpub_date
1991-03-01 00:00:00pages
397-401issue
3eissn
0002-9173issn
1943-7722journal_volume
95pub_type
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