Jump to ContentJump to Main Navigation
Show Summary Details
More options …

Epidemiologic Methods

Edited by faculty of the Harvard School of Public Health

Ed. by Tchetgen Tchetgen, Eric J / VanderWeele, Tyler J. / Daniel, Rhian

1 Issue per year

Online
ISSN
2161-962X
See all formats and pricing
More options …

Use of Individual-level Covariates to Improve Latent Class Analysis of Trypanosoma cruzi Diagnostic Tests

Aaron W. Tustin / Dylan S. Small / Stephen Delgado / Ricardo Castillo Neyra / Manuela R. Verastegui / Jenny M. Ancca Juárez / Víctor R. Quispe Machaca / Robert H. Gilman / Caryn Bern / Michael Z. Levy
Published Online: 2012-08-29 | DOI: https://doi.org/10.1515/2161-962X.1005

Abstract

Statistical methods such as latent class analysis can estimate the sensitivity and specificity of diagnostic tests when no perfect reference test exists. Traditional latent class methods assume a constant disease prevalence in one or more tested populations. When the risk of disease varies in a known way, these models fail to take advantage of additional information that can be obtained by measuring risk factors at the level of the individual. We show that by incorporating complex field-based epidemiologic data, in which the disease prevalence varies as a continuous function of individual-level covariates, our model produces more accurate sensitivity and specificity estimates than previous methods. We apply this technique to several simulated populations and to actual Chagas disease test data from a community near Arequipa, Peru. Results from our model estimate that the first-line enzyme-linked immunosorbent assay has a sensitivity of 78% (95% CI: 62-100%) and a specificity of 100% (95% CI: 99-100%). The confirmatory immunofluorescence assay is estimated to be 73% sensitive (95% CI: 65-81%) and 99% specific (95% CI: 96-100%).

This article offers supplementary material which is provided at the end of the article.

Keywords: Chagas disease; latent class analysis; Trypanosoma cruzi

About the article

Published Online: 2012-08-29


Citation Information: Epidemiologic Methods, Volume 1, Issue 1, Pages 33–54, ISSN (Online) 2161-962X, DOI: https://doi.org/10.1515/2161-962X.1005.

Export Citation

©2012 Walter de Gruyter GmbH & Co. KG, Berlin/Boston.Get Permission

Citing Articles

Here you can find all Crossref-listed publications in which this article is cited. If you would like to receive automatic email messages as soon as this article is cited in other publications, simply activate the “Citation Alert” on the top of this page.

[1]
Robert H. Gilman, Patricia Escalante, Caryn Bern, Gerardo Sanchez, Morgan Marks, Brook Goodhew, Cesar Naquira, Manuela Verastegui, Gerson Galdos-Cardenas, Anthony Halperin, Diana L. Martin, Lisbeth Ferrufino, and Michael Z. Levy
The American Journal of Tropical Medicine and Hygiene, 2014, Volume 90, Number 6, Page 1074
[2]
Mairead L. Bermingham, Ian G. Handel, Elizabeth J. Glass, John A. Woolliams, B. Mark de Clare Bronsvoort, Stewart H. McBride, Robin A. Skuce, Adrian R. Allen, Stanley W. J. McDowell, and Stephen C. Bishop
Scientific Reports, 2015, Volume 5, Number 1

Comments (0)

Please log in or register to comment.
Log in