Immunological investigations provide useful informa-tion to guide diagnosis of several disorders. Many such tests are also commonly repeated at intervals, in an effort to facilitate disease monitoring. In general how-...Immunological investigations provide useful informa-tion to guide diagnosis of several disorders. Many such tests are also commonly repeated at intervals, in an effort to facilitate disease monitoring. In general how-ever, immunology test results are often slow to alter. Furthermore, audit activity has indicated that repeated testing accounts for a substantial workload in many immunology services, which may waste resources and compromise the effcient completion of necessary tests. Consequently, the need and appropriate mini-mum interval between repeated testing requires critical evaluation. In this review, the clinical utility of repeat-ed performance of several common immunology inves-tigations has been evaluated, based upon published evidence. In some cases （ e.g. , paraprotein quantifca-tion, or measurement of anti-glomerular basement membrane antibodies）, repeated testing provides vital clinical information and can be justifed on a frequent and individualized basis. However, many other investi-gations provided by immunology services provide less valuable information when used to aid disease moni-toring rather than diagnosis. It is hoped that the data summarized here will facilitate a more evidence-based approach to repeated testing. Such information may also assist with the local implementation of demand management strategies based upon setting of mini-mum retesting intervals for these investigations.展开更多
We investigated the false-negative,true-negative,false-positive,and true-positive predictive values from a general group testing procedure for a heterogeneous population.We show that its false(true)-negative predictiv...We investigated the false-negative,true-negative,false-positive,and true-positive predictive values from a general group testing procedure for a heterogeneous population.We show that its false(true)-negative predictive value of a specimen is larger(smaller),and the false(true)-positive predictive value is smaller(larger)than that from individual testing procedure,where the former is in aversion.Then we propose a nested group testing procedure,and show that it can keep the sterling characteristics and also improve the false-negative predictive values for a specimen,not larger than that from individual testing.These characteristics are studied from both theoretical and numerical points of view.The nested group testing procedure is better than individual testing on both false-positive and false-negative predictive values,while retains the efficiency as a basic characteristic of a group testing procedure.Applications to Dorfman’s,Halving and Sterrett procedures are discussed.Results from extensive simulation studies and an application to malaria infection in microscopy-negative Malawian women exemplify the findings.展开更多
文摘Immunological investigations provide useful informa-tion to guide diagnosis of several disorders. Many such tests are also commonly repeated at intervals, in an effort to facilitate disease monitoring. In general how-ever, immunology test results are often slow to alter. Furthermore, audit activity has indicated that repeated testing accounts for a substantial workload in many immunology services, which may waste resources and compromise the effcient completion of necessary tests. Consequently, the need and appropriate mini-mum interval between repeated testing requires critical evaluation. In this review, the clinical utility of repeat-ed performance of several common immunology inves-tigations has been evaluated, based upon published evidence. In some cases （ e.g. , paraprotein quantifca-tion, or measurement of anti-glomerular basement membrane antibodies）, repeated testing provides vital clinical information and can be justifed on a frequent and individualized basis. However, many other investi-gations provided by immunology services provide less valuable information when used to aid disease moni-toring rather than diagnosis. It is hoped that the data summarized here will facilitate a more evidence-based approach to repeated testing. Such information may also assist with the local implementation of demand management strategies based upon setting of mini-mum retesting intervals for these investigations.
基金supported by National Natural Science Foundation of China (Grant Nos.11801102,11861017)Beijing Natural Science Foundation (Z180006)the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health.
文摘We investigated the false-negative,true-negative,false-positive,and true-positive predictive values from a general group testing procedure for a heterogeneous population.We show that its false(true)-negative predictive value of a specimen is larger(smaller),and the false(true)-positive predictive value is smaller(larger)than that from individual testing procedure,where the former is in aversion.Then we propose a nested group testing procedure,and show that it can keep the sterling characteristics and also improve the false-negative predictive values for a specimen,not larger than that from individual testing.These characteristics are studied from both theoretical and numerical points of view.The nested group testing procedure is better than individual testing on both false-positive and false-negative predictive values,while retains the efficiency as a basic characteristic of a group testing procedure.Applications to Dorfman’s,Halving and Sterrett procedures are discussed.Results from extensive simulation studies and an application to malaria infection in microscopy-negative Malawian women exemplify the findings.
