Department of Statistics, University of Nebraska-Lincoln, Lincoln, Nebraska, USA.
Department of Statistics, University of South Carolina, Columbia, South Carolina, USA.
Stat Med. 2021 Jun 15;40(13):3021-3034. doi: 10.1002/sim.8954. Epub 2021 Mar 24.
High-volume testing of clinical specimens for sexually transmitted diseases is performed frequently by a process known as group testing. This algorithmic process involves testing portions of specimens from separate individuals together as one unit (or "group") to detect diseases. Retesting is performed on groups that test positively in order to differentiate between positive and negative individual specimens. The overall goal is to use the least number of tests possible across all individuals without sacrificing diagnostic accuracy. One of the most efficient group testing algorithms is array testing. In its simplest form, specimens are arranged into a grid-like structure so that row and column groups can be formed. Positive-testing rows/columns indicate which specimens to retest. With the growing use of multiplex assays, the increasing number of diseases tested by these assays, and the availability of subject-specific risk information, opportunities exist to make this testing process even more efficient. We propose specific specimen arrangements within an array that can reduce the number of retests needed when compared with other array testing algorithms. We examine how to calculate operating characteristics, including the expected number of tests and the SD for the number of tests, and then subsequently find a best arrangement. Our methods are illustrated for chlamydia and gonorrhea detection with the Aptima Combo 2 Assay. We also provide R functions to make our research accessible to laboratories.
大量检测临床标本的性传播疾病经常通过一种称为群体检测的过程来进行。这个算法过程涉及将来自不同个体的标本的部分一起作为一个单元（或“组”）进行检测，以检测疾病。对呈阳性的组进行复测，以区分阳性和阴性个体标本。总体目标是在不牺牲诊断准确性的情况下，在所有个体中使用尽可能少的测试。最有效的群体检测算法之一是阵列检测。在最简单的形式中，标本被排列成网格状结构，以便形成行和列组。阳性测试的行/列表示要进行复测的标本。随着多重检测的广泛应用、这些检测所检测疾病的数量的增加以及个体特定风险信息的可用性，存在使这个检测过程更加高效的机会。我们在数组中提出了特定的标本排列方式，可以与其他数组检测算法相比减少所需的复测次数。我们研究了如何计算操作特性，包括预期测试次数和测试次数的标准差，然后找到最佳排列。我们的方法通过 Aptima Combo 2 检测法对衣原体和淋病的检测进行了说明。我们还提供了 R 函数，以便实验室能够使用我们的研究。
