Issues in human immunodeficiency virus (HIV) screening programs.
Issues in human immunodeficiency virus (HIV) screening programs.
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人类免疫缺陷病毒 (HIV) 筛查计划中的问题。
DOI：
10.1093/oxfordjournals.aje.a116490
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发表时间：
1992
影响因子：
5
通讯作者：
Pagano,M
中科院分区：
文献类型：
--
作者：
Tu,XM;Litvak,E;Pagano,M
与测试灵敏度和特异性不同，假阳性和阴性预测值（对被测个体进行错误标记的概率）在很大程度上取决于人类免疫缺陷病毒 (HIV) 感染的流行情况以及试剂盒的质量。这种依赖性的结果是假阳性预测值可以达到很高的量级，例如 0.9；也就是说，90%的阳性检测结果都是假的。这就提出了与当前艾滋病毒筛查实践相关的许多重要问题，例如如何控制这些错误分类错误、如何解释测试结果以及如何使用测试结果估计患病率。这里通过考虑决定筛查计划质量的因素来详细研究这些问题。使用一些真实的数据示例来说明在设计程序以实现预期目标时考虑这一因素的重要性。研究了艾滋病毒筛查中常见的两步序贯方案背后的基本原理，以指出其在实际情况下的局限性。最后，讨论了熵在评估筛查程序的信息量中的应用。Am J Epidemiol1992；136：244-55。
Unlike test sensitivity and specificity, the false positive and negative predictive values (probabilities of mislabeling an individual being tested) depend heavily on the prevalence of the infection of the human immunodeficiency virus (HIV) as well as the quality of the kit. A consequence of this dependence is that the false positive predictive value can reach a high magnitude such as 0.9; that is, 90% of the positive tests are false. This raises many important issues pertaining to the current practice of HIV screening such as to how to control these misclassification errors, how to interpret test results, and how to estimate prevalence using test results. These issues are examined in detail here by considering the factors that dictate the quality of a screening program. Some real data examples are used to illustrate the importance of this consideration in designing programs to achieve the desired goals. The rationale behind the common two-step sequential protocol in HIV screening is examined to point out its limitations under practical situations. Finally, the use of entropy in evaluating the informativeness of a screening program is discussed.Am J Epidemiol1992;136:244–55.