Estimating the prevalence of multiple diseases from two-stage hierarchical pooling

Md S. Warasi, Joshua M. Tebbs, Christopher S. McMahan, Christopher R. Bilder

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Testing protocols in large-scale sexually transmitted disease screening applications often involve pooling biospecimens (e.g., blood, urine, and swabs) to lower costs and to increase the number of individuals who can be tested. With the recent development of assays that detect multiple diseases, it is now common to test biospecimen pools for multiple infections simultaneously. Recent work has developed an expectation–maximization algorithm to estimate the prevalence of two infections using a two-stage, Dorfman-type testing algorithm motivated by current screening practices for chlamydia and gonorrhea in the USA. In this article, we have the same goal but instead take a more flexible Bayesian approach. Doing so allows us to incorporate information about assay uncertainty during the testing process, which involves testing both pools and individuals, and also to update information as individuals are tested. Overall, our approach provides reliable inference for disease probabilities and accurately estimates assay sensitivity and specificity even when little or no information is provided in the prior distributions. We illustrate the performance of our estimation methods using simulation and by applying them to chlamydia and gonorrhea data collected in Nebraska.

Original languageEnglish (US)
Pages (from-to)3851-3864
Number of pages14
JournalStatistics in Medicine
Volume35
Issue number21
DOIs
StatePublished - Sep 20 2016

Fingerprint

Chlamydia
Pooling
Gonorrhea
Testing
Bayes Theorem
Sexually Transmitted Diseases
Infection
Uncertainty
Screening
Urine
Costs and Cost Analysis
Sensitivity and Specificity
Expectation-maximization Algorithm
Prior distribution
Bayesian Approach
Simulation Methods
Estimate
Specificity
Blood
Update

Keywords

  • Bayesian estimation
  • group testing
  • infertility prevention project
  • pooled testing
  • screening
  • sensitivity
  • specificity

ASJC Scopus subject areas

  • Epidemiology
  • Statistics and Probability

Cite this

Estimating the prevalence of multiple diseases from two-stage hierarchical pooling. / Warasi, Md S.; Tebbs, Joshua M.; McMahan, Christopher S.; Bilder, Christopher R.

In: Statistics in Medicine, Vol. 35, No. 21, 20.09.2016, p. 3851-3864.

Research output: Contribution to journalArticle

Warasi, Md S. ; Tebbs, Joshua M. ; McMahan, Christopher S. ; Bilder, Christopher R. / Estimating the prevalence of multiple diseases from two-stage hierarchical pooling. In: Statistics in Medicine. 2016 ; Vol. 35, No. 21. pp. 3851-3864.
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