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Sequential prevalence estimation with pooling and continuous test outcomes.

Ngoc T Nguyen1, Ebru K Bish1, Hrayer Aprahamian1

  • 1Grado Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, Virginia, 24061, USA.

Statistics in Medicine
|April 25, 2018
PubMed
Summary

This study introduces a sequential estimation procedure for disease prevalence, optimizing pool design for accuracy under budget constraints. The method proves more effective than traditional approaches, especially with limited initial data.

Keywords:
continuous test outcomedilution effectlimited resourcespool designpoolingprevalence estimation

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Area of Science:

  • Epidemiology
  • Biostatistics
  • Public Health

Background:

  • Prevalence estimation is vital for disease control and healthcare planning.
  • Pooled testing is often used due to budget limitations.
  • Existing methods may lack efficiency and robustness.

Purpose of the Study:

  • To develop an efficient sequential estimation procedure for disease prevalence.
  • To optimize pooled testing design considering cost and accuracy trade-offs.
  • To address challenges with limited or inaccurate initial prevalence data.

Main Methods:

  • A sequential estimation procedure incorporating continuous pool readings.
  • Consideration of the dilution effect in pooled testing.
  • An embedded optimization model for designing pool number and size.
  • Numerical simulations to evaluate performance against single-stage methods.

Main Results:

  • The proposed sequential procedure outperforms single-stage and binary outcome methods.
  • The procedure demonstrates robustness with poor initial prevalence estimates.
  • It effectively handles inaccurate assumptions about biomarker load distributions.

Conclusions:

  • The sequential estimation procedure offers an efficient and robust approach to prevalence estimation.
  • It is particularly valuable when initial information is limited or unreliable.
  • The method optimizes pooled testing strategies for better resource allocation and accuracy.