How to Determine the Accuracy of an Alternative Diagnostic Test when It Is Actually Better than the Reference Tests: A Re-Evaluation of Diagnostic Tests for Scrub Typhus Using Bayesian LCMs
The indirect immunofluorescence assay (IFA) is considered a reference test for scrub typhus. Recently, the Scrub Typhus Infection Criteria (STIC; a combination of culture, PCR assays and IFA IgM) were proposed as a reference standard for evaluating alternative diagnostic tests. Here, we use Bayesian...
Gespeichert in:
| Veröffentlicht in: | PloS one 2015-05, Vol.10 (5), p.e0114930-e0114930 |
|---|---|
| Hauptverfasser: | , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | e0114930 |
|---|---|
| container_issue | 5 |
| container_start_page | e0114930 |
| container_title | PloS one |
| container_volume | 10 |
| creator | Lim, Cherry Paris, Daniel H Blacksell, Stuart D Laongnualpanich, Achara Kantipong, Pacharee Chierakul, Wirongrong Wuthiekanun, Vanaporn Day, Nicholas P J Cooper, Ben S Limmathurotsakul, Direk |
| description | The indirect immunofluorescence assay (IFA) is considered a reference test for scrub typhus. Recently, the Scrub Typhus Infection Criteria (STIC; a combination of culture, PCR assays and IFA IgM) were proposed as a reference standard for evaluating alternative diagnostic tests. Here, we use Bayesian latent class models (LCMs) to estimate the true accuracy of each diagnostic test, and of STIC, for diagnosing scrub typhus.
Data from 161 patients with undifferentiated fever were re-evaluated using Bayesian LCMs. Every patient was evaluated for the presence of an eschar, and tested with blood culture for Orientia tsutsugamushi, three different PCR assays, IFA IgM, and the Panbio IgM immunochromatographic test (ICT). True sensitivity and specificity of culture (24.4% and 100%), 56kDa PCR assay (56.8% and 98.4%), 47kDa PCR assay (63.2% and 96.1%), groEL PCR assay (71.4% and 93.0%), IFA IgM (70.0% and 83.8%), PanBio IgM ICT (72.8% and 96.8%), presence of eschar (42.7% and 98.9%) and STIC (90.5% and 82.5%) estimated by Bayesian LCM were considerably different from those obtained when using STIC as a reference standard. The IgM ICT had comparable sensitivity and significantly higher specificity compared to IFA (p=0.34 and p |
| doi_str_mv | 10.1371/journal.pone.0114930 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_plos_</sourceid><recordid>TN_cdi_plos_journals_1684194179</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A432644622</galeid><doaj_id>oai_doaj_org_article_90f820dc4b1f4587a3eb23a9386a59aa</doaj_id><sourcerecordid>A432644622</sourcerecordid><originalsourceid>FETCH-LOGICAL-c692t-dd43606e321a9dff683fa0ddd54142eb2826c0ecd218c0b134ba369c1a7cdc703</originalsourceid><addsrcrecordid>eNqNk9tuEzEQhlcIREvhDRBYQkJwkeBT9sAFUnqARgqq1KbcWhPvbOJqYwfb25KH491w0rRqql6gvfBq_P3_eMaeLHvLaJ-Jgn25cp230PaXzmKfMiYrQZ9l-6wSvJdzKp4_-N_LXoVwRelAlHn-MtvjOeVSFIP97O-puyHRkWOM6BfGIolzJEOtOw96RVxDwJJhmzYtRHON5NjAzLoQjSYTDJHczNGSUSSjkFSxg7ZdkUOMSZCcknZtd44NerQaN5LwlQxTqHdyDW2XTJ1dp3nkG0jjPLnQvpuSyWo57wK5DMbOyCGsMJhkPD76GV5nLxpoA77ZrgfZ5feTydFpb3z2Y3Q0HPd0XvHYq2spcpqj4AyqumnyUjRA67oeSCY5TnnJc01R15yVmk6ZkFMQeaUZFLrWBRUH2ftb32Xrgtp2PiiWl5JVkhVVIka3RO3gSi29WYBfKQdGbQLOzxT4VFyLqqJNyWmt5ZQ1clAWINIJBFTpbmBQASSvb9ts3XSBtUYbPbQ7prs71szVzF0rKWXFiiIZfNoaePe7S91UCxM0ti1YdN3m3INCynyDfniEPl3dlppBKsDYxqW8em2qhlLwPHlxnqj-E1T6alwYnZ5pY1J8R_B5R5CYiH_iDLoQ1Oji_P_Zs1-77McH7ByhjfPg2m791sIuKG9B7V0IHpv7JjOq1lN21w21njK1nbIke_fwgu5Fd2Ml_gHC8iNh</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1684194179</pqid></control><display><type>article</type><title>How to Determine the Accuracy of an Alternative Diagnostic Test when It Is Actually Better than the Reference Tests: A Re-Evaluation of Diagnostic Tests for Scrub Typhus Using Bayesian LCMs</title><source>Public Library of Science (PLoS) Journals Open Access</source><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>Free Full-Text Journals in Chemistry</source><creator>Lim, Cherry ; Paris, Daniel H ; Blacksell, Stuart D ; Laongnualpanich, Achara ; Kantipong, Pacharee ; Chierakul, Wirongrong ; Wuthiekanun, Vanaporn ; Day, Nicholas P J ; Cooper, Ben S ; Limmathurotsakul, Direk</creator><creatorcontrib>Lim, Cherry ; Paris, Daniel H ; Blacksell, Stuart D ; Laongnualpanich, Achara ; Kantipong, Pacharee ; Chierakul, Wirongrong ; Wuthiekanun, Vanaporn ; Day, Nicholas P J ; Cooper, Ben S ; Limmathurotsakul, Direk</creatorcontrib><description>The indirect immunofluorescence assay (IFA) is considered a reference test for scrub typhus. Recently, the Scrub Typhus Infection Criteria (STIC; a combination of culture, PCR assays and IFA IgM) were proposed as a reference standard for evaluating alternative diagnostic tests. Here, we use Bayesian latent class models (LCMs) to estimate the true accuracy of each diagnostic test, and of STIC, for diagnosing scrub typhus.
Data from 161 patients with undifferentiated fever were re-evaluated using Bayesian LCMs. Every patient was evaluated for the presence of an eschar, and tested with blood culture for Orientia tsutsugamushi, three different PCR assays, IFA IgM, and the Panbio IgM immunochromatographic test (ICT). True sensitivity and specificity of culture (24.4% and 100%), 56kDa PCR assay (56.8% and 98.4%), 47kDa PCR assay (63.2% and 96.1%), groEL PCR assay (71.4% and 93.0%), IFA IgM (70.0% and 83.8%), PanBio IgM ICT (72.8% and 96.8%), presence of eschar (42.7% and 98.9%) and STIC (90.5% and 82.5%) estimated by Bayesian LCM were considerably different from those obtained when using STIC as a reference standard. The IgM ICT had comparable sensitivity and significantly higher specificity compared to IFA (p=0.34 and p<0.001, respectively).
The low specificity of STIC was caused by the low specificity of IFA IgM. Neither STIC nor IFA IgM can be used as reference standards against which to evaluate alternative diagnostic tests. Further evaluation of new diagnostic tests should be done with a carefully selected set of diagnostic tests and appropriate statistical models.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0114930</identifier><identifier>PMID: 26024375</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Accuracy ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antigens ; Assaying ; Bacterial infections ; Bayes Theorem ; Bayesian analysis ; Blood culture ; Blood tests ; Care and treatment ; Causes of ; Clinical medicine ; Culture ; Diagnosis ; Diagnostic systems ; Diagnostic tests ; Diagnostic Tests, Routine - standards ; Enzymes ; Ethics ; Evaluation ; Female ; Fever ; Fluorescent Antibody Technique, Indirect ; Health aspects ; Hospitals ; Humans ; Illnesses ; Immunoassay ; Immunofluorescence ; Immunoglobulin M ; Immunoglobulin M - analysis ; Infections ; Male ; Mathematical models ; Medical diagnosis ; Medicine ; Methods ; Middle Aged ; Orientia tsutsugamushi ; Patients ; Physicians ; Polymerase Chain Reaction ; Public health ; Scrub typhus ; Scrub Typhus - diagnosis ; Sensitivity ; Sensitivity and Specificity ; Statistical analysis ; Statistical models ; Tropical diseases ; Typhus ; Young Adult</subject><ispartof>PloS one, 2015-05, Vol.10 (5), p.e0114930-e0114930</ispartof><rights>COPYRIGHT 2015 Public Library of Science</rights><rights>2015 Lim et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2015 Lim et al 2015 Lim et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-dd43606e321a9dff683fa0ddd54142eb2826c0ecd218c0b134ba369c1a7cdc703</citedby><cites>FETCH-LOGICAL-c692t-dd43606e321a9dff683fa0ddd54142eb2826c0ecd218c0b134ba369c1a7cdc703</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4449177/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4449177/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26024375$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lim, Cherry</creatorcontrib><creatorcontrib>Paris, Daniel H</creatorcontrib><creatorcontrib>Blacksell, Stuart D</creatorcontrib><creatorcontrib>Laongnualpanich, Achara</creatorcontrib><creatorcontrib>Kantipong, Pacharee</creatorcontrib><creatorcontrib>Chierakul, Wirongrong</creatorcontrib><creatorcontrib>Wuthiekanun, Vanaporn</creatorcontrib><creatorcontrib>Day, Nicholas P J</creatorcontrib><creatorcontrib>Cooper, Ben S</creatorcontrib><creatorcontrib>Limmathurotsakul, Direk</creatorcontrib><title>How to Determine the Accuracy of an Alternative Diagnostic Test when It Is Actually Better than the Reference Tests: A Re-Evaluation of Diagnostic Tests for Scrub Typhus Using Bayesian LCMs</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>The indirect immunofluorescence assay (IFA) is considered a reference test for scrub typhus. Recently, the Scrub Typhus Infection Criteria (STIC; a combination of culture, PCR assays and IFA IgM) were proposed as a reference standard for evaluating alternative diagnostic tests. Here, we use Bayesian latent class models (LCMs) to estimate the true accuracy of each diagnostic test, and of STIC, for diagnosing scrub typhus.
Data from 161 patients with undifferentiated fever were re-evaluated using Bayesian LCMs. Every patient was evaluated for the presence of an eschar, and tested with blood culture for Orientia tsutsugamushi, three different PCR assays, IFA IgM, and the Panbio IgM immunochromatographic test (ICT). True sensitivity and specificity of culture (24.4% and 100%), 56kDa PCR assay (56.8% and 98.4%), 47kDa PCR assay (63.2% and 96.1%), groEL PCR assay (71.4% and 93.0%), IFA IgM (70.0% and 83.8%), PanBio IgM ICT (72.8% and 96.8%), presence of eschar (42.7% and 98.9%) and STIC (90.5% and 82.5%) estimated by Bayesian LCM were considerably different from those obtained when using STIC as a reference standard. The IgM ICT had comparable sensitivity and significantly higher specificity compared to IFA (p=0.34 and p<0.001, respectively).
The low specificity of STIC was caused by the low specificity of IFA IgM. Neither STIC nor IFA IgM can be used as reference standards against which to evaluate alternative diagnostic tests. Further evaluation of new diagnostic tests should be done with a carefully selected set of diagnostic tests and appropriate statistical models.</description><subject>Accuracy</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antigens</subject><subject>Assaying</subject><subject>Bacterial infections</subject><subject>Bayes Theorem</subject><subject>Bayesian analysis</subject><subject>Blood culture</subject><subject>Blood tests</subject><subject>Care and treatment</subject><subject>Causes of</subject><subject>Clinical medicine</subject><subject>Culture</subject><subject>Diagnosis</subject><subject>Diagnostic systems</subject><subject>Diagnostic tests</subject><subject>Diagnostic Tests, Routine - standards</subject><subject>Enzymes</subject><subject>Ethics</subject><subject>Evaluation</subject><subject>Female</subject><subject>Fever</subject><subject>Fluorescent Antibody Technique, Indirect</subject><subject>Health aspects</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Illnesses</subject><subject>Immunoassay</subject><subject>Immunofluorescence</subject><subject>Immunoglobulin M</subject><subject>Immunoglobulin M - analysis</subject><subject>Infections</subject><subject>Male</subject><subject>Mathematical models</subject><subject>Medical diagnosis</subject><subject>Medicine</subject><subject>Methods</subject><subject>Middle Aged</subject><subject>Orientia tsutsugamushi</subject><subject>Patients</subject><subject>Physicians</subject><subject>Polymerase Chain Reaction</subject><subject>Public health</subject><subject>Scrub typhus</subject><subject>Scrub Typhus - diagnosis</subject><subject>Sensitivity</subject><subject>Sensitivity and Specificity</subject><subject>Statistical analysis</subject><subject>Statistical models</subject><subject>Tropical diseases</subject><subject>Typhus</subject><subject>Young Adult</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNk9tuEzEQhlcIREvhDRBYQkJwkeBT9sAFUnqARgqq1KbcWhPvbOJqYwfb25KH491w0rRqql6gvfBq_P3_eMaeLHvLaJ-Jgn25cp230PaXzmKfMiYrQZ9l-6wSvJdzKp4_-N_LXoVwRelAlHn-MtvjOeVSFIP97O-puyHRkWOM6BfGIolzJEOtOw96RVxDwJJhmzYtRHON5NjAzLoQjSYTDJHczNGSUSSjkFSxg7ZdkUOMSZCcknZtd44NerQaN5LwlQxTqHdyDW2XTJ1dp3nkG0jjPLnQvpuSyWo57wK5DMbOyCGsMJhkPD76GV5nLxpoA77ZrgfZ5feTydFpb3z2Y3Q0HPd0XvHYq2spcpqj4AyqumnyUjRA67oeSCY5TnnJc01R15yVmk6ZkFMQeaUZFLrWBRUH2ftb32Xrgtp2PiiWl5JVkhVVIka3RO3gSi29WYBfKQdGbQLOzxT4VFyLqqJNyWmt5ZQ1clAWINIJBFTpbmBQASSvb9ts3XSBtUYbPbQ7prs71szVzF0rKWXFiiIZfNoaePe7S91UCxM0ti1YdN3m3INCynyDfniEPl3dlppBKsDYxqW8em2qhlLwPHlxnqj-E1T6alwYnZ5pY1J8R_B5R5CYiH_iDLoQ1Oji_P_Zs1-77McH7ByhjfPg2m791sIuKG9B7V0IHpv7JjOq1lN21w21njK1nbIke_fwgu5Fd2Ml_gHC8iNh</recordid><startdate>20150529</startdate><enddate>20150529</enddate><creator>Lim, Cherry</creator><creator>Paris, Daniel H</creator><creator>Blacksell, Stuart D</creator><creator>Laongnualpanich, Achara</creator><creator>Kantipong, Pacharee</creator><creator>Chierakul, Wirongrong</creator><creator>Wuthiekanun, Vanaporn</creator><creator>Day, Nicholas P J</creator><creator>Cooper, Ben S</creator><creator>Limmathurotsakul, Direk</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20150529</creationdate><title>How to Determine the Accuracy of an Alternative Diagnostic Test when It Is Actually Better than the Reference Tests: A Re-Evaluation of Diagnostic Tests for Scrub Typhus Using Bayesian LCMs</title><author>Lim, Cherry ; Paris, Daniel H ; Blacksell, Stuart D ; Laongnualpanich, Achara ; Kantipong, Pacharee ; Chierakul, Wirongrong ; Wuthiekanun, Vanaporn ; Day, Nicholas P J ; Cooper, Ben S ; Limmathurotsakul, Direk</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-dd43606e321a9dff683fa0ddd54142eb2826c0ecd218c0b134ba369c1a7cdc703</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Accuracy</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antigens</topic><topic>Assaying</topic><topic>Bacterial infections</topic><topic>Bayes Theorem</topic><topic>Bayesian analysis</topic><topic>Blood culture</topic><topic>Blood tests</topic><topic>Care and treatment</topic><topic>Causes of</topic><topic>Clinical medicine</topic><topic>Culture</topic><topic>Diagnosis</topic><topic>Diagnostic systems</topic><topic>Diagnostic tests</topic><topic>Diagnostic Tests, Routine - standards</topic><topic>Enzymes</topic><topic>Ethics</topic><topic>Evaluation</topic><topic>Female</topic><topic>Fever</topic><topic>Fluorescent Antibody Technique, Indirect</topic><topic>Health aspects</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Illnesses</topic><topic>Immunoassay</topic><topic>Immunofluorescence</topic><topic>Immunoglobulin M</topic><topic>Immunoglobulin M - analysis</topic><topic>Infections</topic><topic>Male</topic><topic>Mathematical models</topic><topic>Medical diagnosis</topic><topic>Medicine</topic><topic>Methods</topic><topic>Middle Aged</topic><topic>Orientia tsutsugamushi</topic><topic>Patients</topic><topic>Physicians</topic><topic>Polymerase Chain Reaction</topic><topic>Public health</topic><topic>Scrub typhus</topic><topic>Scrub Typhus - diagnosis</topic><topic>Sensitivity</topic><topic>Sensitivity and Specificity</topic><topic>Statistical analysis</topic><topic>Statistical models</topic><topic>Tropical diseases</topic><topic>Typhus</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lim, Cherry</creatorcontrib><creatorcontrib>Paris, Daniel H</creatorcontrib><creatorcontrib>Blacksell, Stuart D</creatorcontrib><creatorcontrib>Laongnualpanich, Achara</creatorcontrib><creatorcontrib>Kantipong, Pacharee</creatorcontrib><creatorcontrib>Chierakul, Wirongrong</creatorcontrib><creatorcontrib>Wuthiekanun, Vanaporn</creatorcontrib><creatorcontrib>Day, Nicholas P J</creatorcontrib><creatorcontrib>Cooper, Ben S</creatorcontrib><creatorcontrib>Limmathurotsakul, Direk</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - Academic</collection><collection>ProQuest Engineering Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Agricultural Science Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Engineering Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lim, Cherry</au><au>Paris, Daniel H</au><au>Blacksell, Stuart D</au><au>Laongnualpanich, Achara</au><au>Kantipong, Pacharee</au><au>Chierakul, Wirongrong</au><au>Wuthiekanun, Vanaporn</au><au>Day, Nicholas P J</au><au>Cooper, Ben S</au><au>Limmathurotsakul, Direk</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>How to Determine the Accuracy of an Alternative Diagnostic Test when It Is Actually Better than the Reference Tests: A Re-Evaluation of Diagnostic Tests for Scrub Typhus Using Bayesian LCMs</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2015-05-29</date><risdate>2015</risdate><volume>10</volume><issue>5</issue><spage>e0114930</spage><epage>e0114930</epage><pages>e0114930-e0114930</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>The indirect immunofluorescence assay (IFA) is considered a reference test for scrub typhus. Recently, the Scrub Typhus Infection Criteria (STIC; a combination of culture, PCR assays and IFA IgM) were proposed as a reference standard for evaluating alternative diagnostic tests. Here, we use Bayesian latent class models (LCMs) to estimate the true accuracy of each diagnostic test, and of STIC, for diagnosing scrub typhus.
Data from 161 patients with undifferentiated fever were re-evaluated using Bayesian LCMs. Every patient was evaluated for the presence of an eschar, and tested with blood culture for Orientia tsutsugamushi, three different PCR assays, IFA IgM, and the Panbio IgM immunochromatographic test (ICT). True sensitivity and specificity of culture (24.4% and 100%), 56kDa PCR assay (56.8% and 98.4%), 47kDa PCR assay (63.2% and 96.1%), groEL PCR assay (71.4% and 93.0%), IFA IgM (70.0% and 83.8%), PanBio IgM ICT (72.8% and 96.8%), presence of eschar (42.7% and 98.9%) and STIC (90.5% and 82.5%) estimated by Bayesian LCM were considerably different from those obtained when using STIC as a reference standard. The IgM ICT had comparable sensitivity and significantly higher specificity compared to IFA (p=0.34 and p<0.001, respectively).
The low specificity of STIC was caused by the low specificity of IFA IgM. Neither STIC nor IFA IgM can be used as reference standards against which to evaluate alternative diagnostic tests. Further evaluation of new diagnostic tests should be done with a carefully selected set of diagnostic tests and appropriate statistical models.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>26024375</pmid><doi>10.1371/journal.pone.0114930</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2015-05, Vol.10 (5), p.e0114930-e0114930 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_1684194179 |
| source | Public Library of Science (PLoS) Journals Open Access; MEDLINE; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Accuracy Adolescent Adult Aged Aged, 80 and over Antigens Assaying Bacterial infections Bayes Theorem Bayesian analysis Blood culture Blood tests Care and treatment Causes of Clinical medicine Culture Diagnosis Diagnostic systems Diagnostic tests Diagnostic Tests, Routine - standards Enzymes Ethics Evaluation Female Fever Fluorescent Antibody Technique, Indirect Health aspects Hospitals Humans Illnesses Immunoassay Immunofluorescence Immunoglobulin M Immunoglobulin M - analysis Infections Male Mathematical models Medical diagnosis Medicine Methods Middle Aged Orientia tsutsugamushi Patients Physicians Polymerase Chain Reaction Public health Scrub typhus Scrub Typhus - diagnosis Sensitivity Sensitivity and Specificity Statistical analysis Statistical models Tropical diseases Typhus Young Adult |
| title | How to Determine the Accuracy of an Alternative Diagnostic Test when It Is Actually Better than the Reference Tests: A Re-Evaluation of Diagnostic Tests for Scrub Typhus Using Bayesian LCMs |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-10T10%3A27%3A24IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=How%20to%20Determine%20the%20Accuracy%20of%20an%20Alternative%20Diagnostic%20Test%20when%20It%20Is%20Actually%20Better%20than%20the%20Reference%20Tests:%20A%20Re-Evaluation%20of%20Diagnostic%20Tests%20for%20Scrub%20Typhus%20Using%20Bayesian%20LCMs&rft.jtitle=PloS%20one&rft.au=Lim,%20Cherry&rft.date=2015-05-29&rft.volume=10&rft.issue=5&rft.spage=e0114930&rft.epage=e0114930&rft.pages=e0114930-e0114930&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0114930&rft_dat=%3Cgale_plos_%3EA432644622%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1684194179&rft_id=info:pmid/26024375&rft_galeid=A432644622&rft_doaj_id=oai_doaj_org_article_90f820dc4b1f4587a3eb23a9386a59aa&rfr_iscdi=true |