{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T09:22:52Z","timestamp":1780564972889,"version":"3.54.1"},"reference-count":45,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2022,6,10]],"date-time":"2022-06-10T00:00:00Z","timestamp":1654819200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"crossref"}]},{"name":"National Center for HIV"},{"name":"Viral Hepatitis"},{"name":"STD"},{"name":"TB Prevention","award":["5 NU38PS004651"],"award-info":[{"award-number":["5 NU38PS004651"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The purpose of this study was to estimate the health impact of syphilis in the United States in terms of the number of quality-adjusted life years (QALYs) lost attributable to infections in 2018.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We developed a Markov model that simulates the natural history and management of syphilis. The model was parameterized by sex and sexual orientation (women who have sex with men, men who have sex with women [MSW], and men who have sex with men [MSM]), and by age at primary infection. We developed a separate decision tree model to quantify health losses due to congenital syphilis. We estimated the average lifetime number of QALYs lost per infection, and the total expected lifetime number of QALYs lost due to syphilis acquired in 2018.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We estimated the average number of discounted lifetime QALYs lost per infection as 0.09 (95% uncertainty interval [UI] .03\u2013.19). The total expected number of QALYs lost due to syphilis acquired in 2018 was 13 349 (5071\u201331 360). Although per-case loss was the lowest among MSM (0.06), MSM accounted for 47.7% of the overall burden. For each case of congenital syphilis, we estimated 1.79 (1.43\u20132.16) and 0.06 (.01\u2013.14) QALYs lost in the child and the mother, respectively. We projected 2332 (1871\u201328 250) and 79 (17\u2013177) QALYs lost for children and mothers, respectively, due to congenital syphilis in 2018.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Syphilis causes substantial health losses in adults and children. Quantifying these health losses in terms of QALYs can inform cost-effectiveness analyses and can facilitate comparisons of the burden of syphilis to that of other diseases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciac427","type":"journal-article","created":{"date-parts":[[2022,6,10]],"date-time":"2022-06-10T01:13:06Z","timestamp":1654823586000},"page":"e810-e819","source":"Crossref","is-referenced-by-count":21,"title":["Estimation of the Lifetime Quality-Adjusted Life Years (QALYs) Lost Due to Syphilis Acquired in the United States in 2018"],"prefix":"10.1093","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0013-4733","authenticated-orcid":false,"given":"Kyueun","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Health Policy and Management, Graduate School of Public Health, University of Pittsburgh , Pittsburgh, Pennsylvania , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiying","family":"You","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, Yale School of Public Health , New Haven, Connecticut , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunfei","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Global Health and Population, Harvard T. 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Chan School of Public Health , Boston, Massachusetts , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harrell","family":"Chesson","sequence":"additional","affiliation":[{"name":"Division of STD Prevention, Centers for Disease Control and Prevention , Atlanta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas L","family":"Gift","sequence":"additional","affiliation":[{"name":"Division of STD Prevention, Centers for Disease Control and Prevention , Atlanta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9s A","family":"Berruti","sequence":"additional","affiliation":[{"name":"Division of STD Prevention, Centers for Disease Control and Prevention , Atlanta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Hsu","sequence":"additional","affiliation":[{"name":"Sexually Transmitted Disease Prevention & HIV\/AIDS Surveillance, Massachusetts Department of Public Health , Boston, Massachusetts , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reza","family":"Yaesoubi","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, Yale School of Public Health , New Haven, Connecticut , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua A","family":"Salomon","sequence":"additional","affiliation":[{"name":"Center for Health Policy\/Center for Primary Care & Outcomes Research, Stanford University , Stanford, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minttu","family":"R\u00f6nn","sequence":"additional","affiliation":[{"name":"Department of Global Health and Population, Harvard T. 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