The figure shows the recommended algorithm for reverse sequence syphilis screening (treponemal test screening followed by nontreponemal test confirmation). CDC recommends that a specimen with reactive EIA/CIA results be tested reflexively with a quantitative nontreponemal test (e.g., RPR or VDRL). If test results are discordant, the specimen should be tested reflexively using the TP-PA test as a confirmatory treponemal test. Discordant Results from Reverse Sequence Syphilis Screening --- Five Laboratories, United States, 2006--2010 WeeklyFebruary 11, 2011 / 60(05);133-137