Different latent class models were used and evaluated for assessing the accuracy of campylobacter diagnostic tests: overcoming imperfect reference standards?

Asselineau, J; Paye, A; Bessède, E; Perez, P; Proust-Lima, C

Asselineau, J; Paye, A; Bessède, E; Perez, P; Proust-Lima, C.

Afiliación

Asselineau J; Bordeaux University Hospital,Public Health Department, Clinical Epidemiology Unit,F-33076 Bordeaux,France.
Paye A; Bordeaux University Hospital,Public Health Department, Clinical Epidemiology Unit,F-33076 Bordeaux,France.
Bessède E; French National Reference Center for Campylobacter and Helicobacter,F-33076 Bordeaux,France.
Perez P; Bordeaux University Hospital,Public Health Department, Clinical Epidemiology Unit,F-33076 Bordeaux,France.
Proust-Lima C; Bordeaux University Hospital,Public Health Department, Clinical Epidemiology Unit,F-33076 Bordeaux,France.

Epidemiol Infect ; 146(12): 1556-1564, 2018 09.

Article en En | MEDLINE | ID: mdl-29945689

RESUMEN

In the absence of perfect reference standard, classical techniques result in biased diagnostic accuracy and prevalence estimates. By statistically defining the true disease status, latent class models (LCM) constitute a promising alternative. However, LCM is a complex method which relies on parametric assumptions, including usually a conditional independence between tests and might suffer from data sparseness. We carefully applied LCMs to assess new campylobacter infection detection tests for which bacteriological culture is an imperfect reference standard. Five diagnostic tests (culture, polymerase chain reaction and three immunoenzymatic tests) of campylobacter infection were collected in 623 patients from Bordeaux and Lyon Hospitals, France. Their diagnostic accuracy were estimated with standard and extended LCMs with a thorough examination of models goodness-of-fit. The model including a residual dependence specific to the immunoenzymatic tests best complied with LCM assumptions. Asymptotic results of goodness-of-fit statistics were substantially impaired by data sparseness and empirical distributions were preferred. Results confirmed moderate sensitivity of the culture and high performances of immunoenzymatic tests. LCMs can be used to estimate diagnostic tests accuracy in the absence of perfect reference standard. However, their implementation and assessment require specific attention due to data sparseness and limitations of existing software.

Asunto(s)

Infecciones por Campylobacter/diagnóstico; Pruebas Diagnósticas de Rutina/normas; Diagnóstico Diferencial; Ensayo de Inmunoadsorción Enzimática; Heces/microbiología; Francia; Humanos; Inmunoensayo; Análisis de Clases Latentes; Modelos Estadísticos; Reacción en Cadena de la Polimerasa; Estándares de Referencia; Sensibilidad y Especificidad; Programas Informáticos

Palabras clave

Campylobacter; diagnostic accuracy; imperfect gold standard; latent class model; sparseness

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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por Campylobacter / Pruebas Diagnósticas de Rutina Tipo de estudio: Diagnostic_studies / Guideline / Prognostic_studies / Risk_factors_studies Límite: Humans País/Región como asunto: Europa Idioma: En Revista: Epidemiol Infect Asunto de la revista: DOENCAS TRANSMISSIVEIS / EPIDEMIOLOGIA Año: 2018 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Reino Unido

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