Reverse-sequence screening · Tp EIA → RPR → TP-PA

Syphilis serology, read as a posterior

Each test updates the probability that a real T. pallidum antibody response is present. The tie-breaker — TP-PA after a positive EIA but non-reactive RPR — is where conditional independence quietly breaks, because both treponemal assays chase the same antibody.

Pretest probability of infection
Clinical stage — shifts the sensitivities
Stage presets reset the test characteristics

Sensitivities move most across stages; specificities barely. Edit any value below to override.

Your patient's result
The cascade · posterior probability of true infection at each outcome
What the number means
  • The posterior is P(genuine T. pallidum infection) — active, latent, or past/treated. It does not by itself separate active from treated disease; that is the work of the RPR titer plus treatment history.
  • RPR is modeled independently of EIA (different antibody target — cardiolipin vs. treponemal protein). EIA and TP-PA are not: their dependence is carried by TP-PA's conditional specificity among EIA-positives (default 96% vs. % marginal). The gap is why the EIA+/RPR−/TP-PA+ node shows two posteriors.
  • Defaults are editable literature ballparks for Tp EIA/CIA, RPR, and TP-PA — set them to your lab's validated performance and local stage mix. Sensitivities move a lot by stage; use the toggle.

Educational tool · not a substitute for clinical judgment, titers, or direct detection (darkfield/PCR).