Evaluation of the Accuracy of Diagnostic Tests From Repeated Measurements Without a Gold Standard |
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Authors: | Bas Engel Jantien Backer Willem Buist |
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Affiliation: | (1) Key Laboratory of Animal Virology of the Ministry of Agriculture, State Key Laboratory of Veterinary Etiological Biology, National Foot-and-Mouth Disease Reference Laboratory, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, 730046, China; |
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Abstract: | A model is presented to evaluate the accuracy of diagnostic tests from data from individuals that are repeatedly tested in
time. Repeated measurements from three diagnostic tests for foot-and-mouth disease, applied to vaccinated and experimentally
infected cattle, were analyzed. At any time the true disease status of the individuals was unknown, i.e., no gold standard
was available. The model allows for correlation between repeated test results, in consequence of the underlying structure
for the unknown true disease status, but also by the distribution of the test results conditional upon true disease status.
The model also allows for dependence between the different diagnostic tests conditional upon true disease status. Prior information
about the structure of the prevalence and the specificity of the tests was incorporated in a Bayesian analysis. Posterior
inference was carried out with Markov chain Monte Carlo. Simulated data were analyzed to gain insight into the performance
of the posterior Bayesian inference. The simulated data are typical for the expensive and, therefore, modestly sized infection
experiments that are conducted under controlled conditions. |
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Keywords: | |
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