Using latent class analysis to estimate the test characteristics of the γ-interferon test, the single intradermal comparative tuberculin test and a multiplex immunoassay under Irish conditions
Using latent class analysis to estimate the test characteristics of the γ-interferon test, the single intradermal comparative tuberculin test and a multiplex immunoassay under Irish conditions
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DOI：
10.1016/j.vetmic.2011.02.027
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发表时间：
2011-07-05
影响因子：
3.3
通讯作者：
More, Simon J.
中科院分区：
文献类型：
--
作者：
Clegg, Tracy A.;Duignan, Anthony;More, Simon J.
已经做出了相当大的努力来改进现有的牛结核病诊断试验（单一皮内比较结核菌素试验[SICTT]和γ-干扰素试验[γ-IFN]）并开发新的试验。以前，诊断特征（灵敏度，特异性）已在具有确定感染状态的人群中进行了估计。然而，这些方法可能是有问题的，因为在爱尔兰可能很少有保证不受感染的牛群。我们使用潜在类模型来估计现有的（SICTT和γ-IFN）和新的（多重免疫测定[Enferplex-TB]）诊断测试在爱尔兰的现场条件下，真正的疾病状态是未知的诊断特征。研究群体包括在没有已知TB问题的地区招募的畜群（2197头动物）和经历确认的TB分解的畜群（2740头动物）。开发了贝叶斯模型，允许SICTT和γ-IFN之间的依赖性，同时假设独立于Enferplex-TB测试。不同的测试解释被用于分析：SICTT（标准和严重的解释），γ-IFN（单一的解释），和一系列的解释Enferplex-TB（1级[高灵敏度解释]到5级[高特异性解释]）。SICTT[标准]相对于Enferplex-TB[1级]和γ-IFN的敏感性和特异性（95%后验可信区间; 95%PCI）分别为52.9-60.8%和99.2- 99.8%。γ-IFN相对于Enferplex-TB[水平-1]和SICTT的等效估计值分别为63.1-70.1%和86.8- 89.4%。Enferplex-TB[1级]的敏感性（95%PCI：64.8-71.9%）上级SICTT[标准]，Enferplex-TB[5级]的特异性上级γ-IFN（95%PCI：99.6-100.0%）。这些结果提供了爱尔兰田间条件下灵敏度和特异性的可靠测量，并表明Enferplex-TB检测有可能改善目前牛TB感染的诊断。这种潜力的程度将在进一步的研究中评估。(C)2011 Elsevier B. V.保留所有权利。
Considerable effort has been devoted to improving the existing diagnostic tests for bovine tuberculosis (single intradermal comparative tuberculin test [SICTT] and gamma-interferon assay [gamma-IFN]) and to develop new tests. Previously, the diagnostic characteristics (sensitivity, specificity) have been estimated in populations with defined infection status. However, these approaches can be problematic as there may be few herds in Ireland where freedom from infection is guaranteed. We used latent class models to estimate the diagnostic characteristics of existing (SICTT and gamma-IFN) and new (multiplex immunoassay [Enferplex-TB]) diagnostic tests under Irish field conditions where true disease status was unknown. The study population consisted of herds recruited in areas with no known TB problems (2197 animals) and herds experiencing a confirmed TB breakdown (2740 animals). A Bayesian model was developed, allowing for dependence between SICTT and gamma-IFN, while assuming independence from the Enferplex-TB test. Different test interpretations were used for the analysis: SICTT (standard and severe interpretation), gamma-IFN (a single interpretation), and a range of interpretations for the Enferplex-TB (level-1 [high sensitivity interpretation] to level-5 [high specificity interpretation]). The sensitivity and specificity (95% posterior credibility intervals; 95% PCI) of SICTT[standard] relative to Enferplex-TB[level-1] and gamma-IFN were 52.9-60.8% and 99.2-99.8%, respectively. Equivalent estimates for gamma-IFN relative to Enferplex-TB[level-1] and SICTT were 63.1-70.1% and 86.8-89.4%, respectively. Sensitivity of Enferplex-TB[level-1] (95% PCI: 64.8-71.9%) was superior to the SICTT[standard], and specificity of the Enferplex-TB[level-5] was superior to gamma-IFN (95% PCI: 99.6-100.0%). These results provide robust measures of sensitivity and specificity under field conditions in Ireland and suggest that the Enferplex-TB test has the potential to improve on current diagnostics for TB infection in cattle. The extent of that potential will be assessed in further studies. (C) 2011 Elsevier B.V. All rights reserved.