We have located links that may give you full text access.
Adjusting Incidence Estimates with Laboratory Test Performances: A Pragmatic Maximum Likelihood Estimation-Based Approach.
Epidemiology 2024 March 7
Understanding the incidence of disease is often crucial for public policy decision-making, as observed during the COVID-19 pandemic. Estimating incidence is challenging, however, when the definition of incidence relies on tests that imperfectly measure disease, as in the case when assays with variable performance are used to detect the SARS-CoV-2 virus. To our knowledge there are no pragmatic methods to address the bias introduced by performance of labs in testing for the virus. In the setting of a longitudinal study, we developed a maximum likelihood estimation (MLE)-based approach to estimate laboratory performance-adjusted incidence using the expectation-maximization algorithm. We constructed confidence intervals (CIs) using both bootstrapped-based and large-sample interval estimator approaches. We evaluated our methods through extensive simulation and applied them to a real-world study (TrackCOVID), where the primary goal was to determine the incidence of and risk factors for SARS-CoV-2 infection in the San Francisco Bay Area during July 2020 to March 2021. Our simulations demonstrated that our method converged rapidly with accurate estimates under a variety of scenarios. Bootstrapped-based confidence intervals (CIs) were comparable to the large-sample estimator CIs with a reasonable number of incident cases, shown via a simulation scenario based on the real TrackCOVID study. In more extreme simulated scenarios, the coverage of large-sample interval estimation outperformed the bootstrapped-based approach. Results from application to the TrackCOVID Study suggested that assuming perfect laboratory test performance can lead to inaccurate inference of the incidence. Our flexible, pragmatic method can be extended to a variety of disease and study settings.
Full text links
Related Resources
Trending Papers
Insomnia in older adults: A review of treatment options.Cleveland Clinic Journal of Medicine 2025 January 2
How We Treat ANCA-Associated Vasculitis: A Focus on the Maintenance Therapy.Journal of Clinical Medicine 2025 January 2
Allergic rhinitis.Allergy, Asthma, and Clinical Immunology 2024 December 27
Chronic Lymphocytic Leukemia: 2025 Update on the Epidemiology, Pathogenesis, Diagnosis, and Therapy.American Journal of Hematology 2025 January 28
Sepsis-induced cardiogenic shock: controversies and evidence gaps in diagnosis and management.Journal of Intensive Care 2025 January 2
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2025 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app