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Estimating prevalence and test accuracy in disease ecology: How Bayesian latent class analysis can boost or bias imperfect test results

1. Obtaining accurate estimates of disease prevalence is crucial for the monitoring and management of wildlife populations but can be difficult if different diagnostic tests yield conflicting results and if the accuracy of each diagnostic test is unknown. Bayesian latent class analysis (BLCA) modeli...

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Autores principales: Helman, Sarah K., Mummah, Riley O., Gostic, Katelyn M., Buhnerkempe, Michael G., Prager, Katherine C., Lloyd‐Smith, James O.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7391344/
https://www.ncbi.nlm.nih.gov/pubmed/32760523
http://dx.doi.org/10.1002/ece3.6448
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author Helman, Sarah K.
Mummah, Riley O.
Gostic, Katelyn M.
Buhnerkempe, Michael G.
Prager, Katherine C.
Lloyd‐Smith, James O.
author_facet Helman, Sarah K.
Mummah, Riley O.
Gostic, Katelyn M.
Buhnerkempe, Michael G.
Prager, Katherine C.
Lloyd‐Smith, James O.
author_sort Helman, Sarah K.
collection PubMed
description 1. Obtaining accurate estimates of disease prevalence is crucial for the monitoring and management of wildlife populations but can be difficult if different diagnostic tests yield conflicting results and if the accuracy of each diagnostic test is unknown. Bayesian latent class analysis (BLCA) modeling offers a potential solution, providing estimates of prevalence levels and diagnostic test accuracy under the realistic assumption that no diagnostic test is perfect. 2. In typical applications of this approach, the specificity of one test is fixed at or close to 100%, allowing the model to simultaneously estimate the sensitivity and specificity of all other tests, in addition to infection prevalence. In wildlife systems, a test with near‐perfect specificity is not always available, so we simulated data to investigate how decreasing this fixed specificity value affects the accuracy of model estimates. 3. We used simulations to explore how the trade‐off between diagnostic test specificity and sensitivity impacts prevalence estimates and found that directional biases depend on pathogen prevalence. Both the precision and accuracy of results depend on the sample size, the diagnostic tests used, and the true infection prevalence, so these factors should be considered when applying BLCA to estimate disease prevalence and diagnostic test accuracy in wildlife systems. A wildlife disease case study, focusing on leptospirosis in California sea lions, demonstrated the potential for Bayesian latent class methods to provide reliable estimates under real‐world conditions. 4. We delineate conditions under which BLCA improves upon the results from a single diagnostic across a range of prevalence levels and sample sizes, demonstrating when this method is preferable for disease ecologists working in a wide variety of pathogen systems.
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spelling pubmed-73913442020-08-04 Estimating prevalence and test accuracy in disease ecology: How Bayesian latent class analysis can boost or bias imperfect test results Helman, Sarah K. Mummah, Riley O. Gostic, Katelyn M. Buhnerkempe, Michael G. Prager, Katherine C. Lloyd‐Smith, James O. Ecol Evol Original Research 1. Obtaining accurate estimates of disease prevalence is crucial for the monitoring and management of wildlife populations but can be difficult if different diagnostic tests yield conflicting results and if the accuracy of each diagnostic test is unknown. Bayesian latent class analysis (BLCA) modeling offers a potential solution, providing estimates of prevalence levels and diagnostic test accuracy under the realistic assumption that no diagnostic test is perfect. 2. In typical applications of this approach, the specificity of one test is fixed at or close to 100%, allowing the model to simultaneously estimate the sensitivity and specificity of all other tests, in addition to infection prevalence. In wildlife systems, a test with near‐perfect specificity is not always available, so we simulated data to investigate how decreasing this fixed specificity value affects the accuracy of model estimates. 3. We used simulations to explore how the trade‐off between diagnostic test specificity and sensitivity impacts prevalence estimates and found that directional biases depend on pathogen prevalence. Both the precision and accuracy of results depend on the sample size, the diagnostic tests used, and the true infection prevalence, so these factors should be considered when applying BLCA to estimate disease prevalence and diagnostic test accuracy in wildlife systems. A wildlife disease case study, focusing on leptospirosis in California sea lions, demonstrated the potential for Bayesian latent class methods to provide reliable estimates under real‐world conditions. 4. We delineate conditions under which BLCA improves upon the results from a single diagnostic across a range of prevalence levels and sample sizes, demonstrating when this method is preferable for disease ecologists working in a wide variety of pathogen systems. John Wiley and Sons Inc. 2020-06-15 /pmc/articles/PMC7391344/ /pubmed/32760523 http://dx.doi.org/10.1002/ece3.6448 Text en © 2020 The Authors. Ecology and Evolution published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Research
Helman, Sarah K.
Mummah, Riley O.
Gostic, Katelyn M.
Buhnerkempe, Michael G.
Prager, Katherine C.
Lloyd‐Smith, James O.
Estimating prevalence and test accuracy in disease ecology: How Bayesian latent class analysis can boost or bias imperfect test results
title Estimating prevalence and test accuracy in disease ecology: How Bayesian latent class analysis can boost or bias imperfect test results
title_full Estimating prevalence and test accuracy in disease ecology: How Bayesian latent class analysis can boost or bias imperfect test results
title_fullStr Estimating prevalence and test accuracy in disease ecology: How Bayesian latent class analysis can boost or bias imperfect test results
title_full_unstemmed Estimating prevalence and test accuracy in disease ecology: How Bayesian latent class analysis can boost or bias imperfect test results
title_short Estimating prevalence and test accuracy in disease ecology: How Bayesian latent class analysis can boost or bias imperfect test results
title_sort estimating prevalence and test accuracy in disease ecology: how bayesian latent class analysis can boost or bias imperfect test results
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7391344/
https://www.ncbi.nlm.nih.gov/pubmed/32760523
http://dx.doi.org/10.1002/ece3.6448
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