Using group testing in a two-phase epidemiologic design to identify the effects of a large number of antibody reactions on disease risk
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Updated: Aug 17, 2025

Author Spotlight: Expanding the Scope of Multiplex Immunoassays for Lyme Borreliosis Diagnostics and Pathogen Research
Published on: July 14, 2023
Tanvi Mehta1, Yaakov Malinovsky2, Christian C Abnet1
1Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Room SG/7E146, Rockville, MD, 20850, USA.
Background:
The role of immunological responses to exposed bacteria on disease incidence is increasingly under investigation. With many bacterial species, and many potential antibody reactions to a particular species, the large number of assays required for this type of discovery can make it prohibitively expensive. We propose a two-phase group testing design to more efficiently screen numerous antibody effects in a case-control setting.
Methods:
Phase 1 uses group testing to select antibodies that are differentially expressed between cases and controls. The selected antibodies go on to Phase 2 individual testing.
Results:
We evaluate the two-phase group testing design through simulations and example data and find that it substantially reduces the number of assays required relative to standard case-control and group testing designs, while maintaining similar statistical properties.
Conclusion:
The proposed two-phase group testing design can dramatically reduce the number of assays required, while providing comparable results to a case-control design.
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