{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T04:12:50Z","timestamp":1784693570926,"version":"3.55.0"},"reference-count":78,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[1986,5,1]],"date-time":"1986-05-01T00:00:00Z","timestamp":515289600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ann Otol Rhinol Laryngol"],"published-print":{"date-parts":[[1986,5]]},"abstract":"<jats:p>Otologic syphilis (luetic inner ear disease) usually is diagnosed by positive serologic tests and by exclusion of other possible causes. Because the FTA-ABS for syphilis is exquisitely sensitive in all but early primary cases, a positive FTA-ABS result and coincident inner ear disease often are thought to be diagnostic of syphilitic inner ear disease. The result is a management dilemma: are there false-positive results in misdiagnosed cases? Over 4 years, the authors performed a prospective study with time-matched controls to determine the predictive value of serologic tests and prevalence of syphilis in otology. Thirty-one cases of otologic syphilis were diagnosed in 5,439 new (different) patients with otologic complaints. In the geographic area studied, this prevalence (570\/100,000) was 25-fold greater than that of all reported cases of syphilis in the general population (22.7\/100,000). The defined sensitivity of the FTA-ABS (100%) was nearly twofold greater than the measured sensitivity of the rapid plasma reagin (RPR, 55%) in otologic syphilis. Specificities were comparable; therefore, a positive FTA-ABS had higher predictive value than a positive RPR. The prevalence-related predictive value of a positive FTA-ABS (22%) was more than twice that of the RPR (9%) in otology. The predictive value of a positive FTA-ABS in otology was 11-fold greater than that of the FTA-ABS in the general population (2%). Therefore, in suspect cases the FTA-ABS should be used to screen for otologic syphilis in an otologic practice. At a prevalence of 570 cases in 100,000 patients, only 22% of otologic patients with positive FTA-ABS results actually have otologic syphilis. Because disease morbidity can be far worse than treatment morbidity, however, positive results should be considered true-positives to avoid misdiagnosis in potentially infected patients. In suspect cases with positive FTA-ABS, therefore, treatment should be recommended unless specific contraindications exist.<\/jats:p>","DOI":"10.1177\/000348948609500308","type":"journal-article","created":{"date-parts":[[2014,10,3]],"date-time":"2014-10-03T14:35:41Z","timestamp":1412346941000},"page":"250-259","source":"Crossref","is-referenced-by-count":40,"title":["Predictive Value of Serologic Tests for Syphilis in Otology"],"prefix":"10.1177","volume":"95","author":[{"given":"Gordon B.","family":"Hughes","sequence":"first","affiliation":[{"name":"Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isobel","family":"Rutherford","sequence":"additional","affiliation":[{"name":"Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[1986,5,1]]},"reference":[{"key":"bibr1-000348948609500308","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-198106000-00006"},{"key":"bibr2-000348948609500308","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1983.03330460051031"},{"key":"bibr3-000348948609500308","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1966.00760020020008"},{"key":"bibr4-000348948609500308","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1968.00760060380008"},{"key":"bibr5-000348948609500308","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-198312000-00003"},{"key":"bibr6-000348948609500308","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1978.00790020005001"},{"key":"bibr7-000348948609500308","doi-asserted-by":"crossref","first-page":"1135","DOI":"10.1288\/00005537-197907000-00013","volume":"89","author":"Pillsbury HC","year":"1979","journal-title":"Laryngoscope"},{"key":"bibr8-000348948609500308","doi-asserted-by":"publisher","DOI":"10.1002\/lary.1979.89.8.1273"},{"key":"bibr9-000348948609500308","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1976.00780170047005"},{"key":"bibr10-000348948609500308","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-12-387050-6.50022-0"},{"key":"bibr11-000348948609500308","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1128\/jcm.9.3.369-372.1979","volume":"9","author":"Peter CR","year":"1979","journal-title":"J Clin Microbiol"},{"key":"bibr12-000348948609500308","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-83-6-846"},{"key":"bibr13-000348948609500308","volume-title":"Beyond normality: the predictive value and efficiency of medical diagnoses","author":"Galen RS","year":"1975"},{"key":"bibr14-000348948609500308","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-2712(18)31007-2"},{"key":"bibr15-000348948609500308","first-page":"898","volume-title":"Harrison's principles of internal medicine","author":"Heyman A","year":"1970","edition":"6"},{"key":"bibr16-000348948609500308","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-197306000-00003"},{"key":"bibr17-000348948609500308","volume-title":"A clinical memoir on certain diseases of the eye and ear consequent on inherited syphilis","author":"Hutchinson J","year":"1863"},{"key":"bibr18-000348948609500308","unstructured":"Schuknecht HF. 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