Canadian Public Health Laboratory Network national syphilis in-laboratory serological testing recommendations
Bibliographic record
Abstract
Syphilis, caused by the bacterium Treponema pallidum, is a centuries-old sexually transmitted disease that continues to be a significant global health concern. Despite the efficacy of penicillin the disease has seen a resurgence worldwide, including in Canada. In 2022, Canada reported 13,953 cases of infectious syphilis, representing a 109% increase since 2018, and 117 cases of congenital syphilis, a staggering 599% increase. Historically, gay and bisexual men who have sex with men have been predominantly affected; however, recent years have seen a significant rise in female cases, contributing to the increase in congenital syphilis. Syphilis diagnosis is complex, requiring specialized expertise. The Canadian Public Health Laboratory Network last updated its laboratory diagnosis guidelines in 2015. Given the advancements in diagnostic techniques and the pressing need for updated guidance, this document provides an overview of the syphilis-causing pathogen T. pallidum, its transmission, pathogenesis, and clinical manifestations. It also reviews the epidemiology of syphilis, highlighting recent trends in Canada, and discusses current and emerging serological laboratory diagnostic techniques. This updated guidance aims to equip health care professionals with the latest knowledge and recommended testing algorithms to accurately diagnose and manage syphilis, ultimately helping to address the rising rates of this disease and improve public health outcomes in Canada.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.012 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.006 | 0.006 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.004 | 0.001 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.021 | 0.008 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".