How Reliable Are Tests for Trachoma?-A Latent Class Approach
How Reliable Are Tests for Trachoma?-A Latent Class Approach
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DOI：
10.1167/iovs.11-7419
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发表时间：
2011-08-01
影响因子：
4.4
通讯作者：
Lietman, Thomas M.
中科院分区：
文献类型：
--
作者：
See, Craig W.;Alemayehu, Wondu;Lietman, Thomas M.
目的.由于没有金标准测试，眼部沙眼衣原体的测试还没有得到很好的表征。在缺乏金标准的情况下，进行潜在类别分析（LCA）以评估实验室和临床试验对沙眼的敏感性和特异性。使用了来自治疗前埃塞俄比亚高流行区的个体数据。对三种诊断试验进行聚类LCA：PCR和WHO简化标准等级的滤泡性沙眼（TF）和严重沙眼性炎症（TI）。数据来自40个村庄的2111名受试者。TF估计为87.3%（95% CI，83.3-90.1）敏感和36.6%（95% CI，23.6-40.3）特异性; TI估计为53.6%（95% CI，46.1-88.0）敏感和88.3% PCR的敏感性为87.5%（95%CI，79.9-97.2），特异性为100%（95%CI，69.3-100）。LCA允许在不预先假设其性能的情况下估计测试特性。TF和TI被发现以互补的方式起作用：TF是一种敏感的测试，TI是一种特异性测试。PCR具有高度特异性，但缺乏敏感性。这些测试的性能可能是由于眼部衣原体感染的时间过程，因此，结果可能会有所不同，在低患病率或最近的大规模治疗（ClinicalTrials.gov编号，NCT 00221364）的领域。（Invest Ophthalmol维斯科学。2011; 52：6133-6137）DOI：10.1167/iovs.117419
PURPOSE. Tests for ocular Chlamydia trachomatis have not been well characterized, because there is no gold standard test. Latent class analysis (LCA) was performed to estimate the sensitivity and specificity of laboratory and clinical tests for trachoma in the absence of a gold standard.METHODS. Individual data from pretreatment, hyperendemic areas in Ethiopia were used. A clustered LCA was performed for three diagnostic tests: PCR and WHO simplified criteria grades of follicular trachoma (TF) and intense trachomatous inflammation (TI).RESULTS. Data from 2111 subjects in 40 villages were available. TF was estimated to be 87.3% (95% CI, 83.3-90.1) sensitive and 36.6% (95% CI, 23.6-40.3) specific; TI was estimated to be 53.6% (95% CI, 46.1-88.0) sensitive and 88.3% (95% CI, 83.3-92.0) specific, and PCR was estimated to be 87.5% (95% CI, 79.9-97.2) sensitive and 100% (95% CI 69.3-100) specific.CONCLUSIONS. LCA allows for an estimate of test characteristics without prior assumption of their performance. TF and TI were found to act in a complementary manner: TF is a sensitive test and TI is a specific test. PCR is highly specific but lacks sensitivity. The performance of these tests may be due to the time course of ocular chlamydial infection, and for this reason, results may differ in areas of low prevalence or recent mass treatment (ClinicalTrials.gov number, NCT00221364). (Invest Ophthalmol Vis Sci. 2011; 52: 6133-6137) DOI:10.1167/iovs.117419