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Deciding how to target tests to populations is a major theme this month. The balance between speed of diagnosis, sensitivity and specificity, predictive value, and treatment rates is ever-changing. In this month's Editor's Choice, Lusk et al1 (see page 227) present Australian data suggesting that Trichomonas vaginalis may be substantially underdiagnosed with existing policies for the discretionary use of wet mounts. As screening strategies for cervical dysplasia evolve—for example, the age at which cervical screening starts in England is now 25 years—we can expect to see changes in the epidemiology of this parasite, which has been well controlled in recent decades. What are the implications for testing patterns? The trade-off between rapid diagnosis and sensitivity in the diagnosis of syphilis is nicely demonstrated by Mishra et al2 (see page 193) in an evaluation of a rapid …
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