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Biostatistics Advance Access published online on June 9, 2005
Biostatistics, doi:10.1093/biostatistics/kxi039
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© The Author 2005. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oupjournals.org.
Received January 9, 2004
Revised May 27, 2005
Accepted June 1, 2005

Article

Bayesian inference for prevalence and diagnostic test accuracy based on dual pooled screening

Timothy E. Hanson 1*, Wesley O. Johnson 2, and Joseph L. Gastwirth 3

1 Division of Biostatistics, Department of Public Health, University of Minnesota, Minneapolis MN 55455
2 Department of Statistics, University of California, Davis, CA 95616
3 Department of Statistics, George Washington University, Washington D.C. 20052

* To whom correspondence should be addressed.
Timothy E. Hanson, E-mail: hanson{at}biostat.umn.edu


  Abstract

We propose a useful protocol for the problem of screening populations for low prevalence characteristics such as HIV or drugs. Current HIV screening of blood that has been donated for transfusion involves the testing of individual blood units with an inexpensive ELISA test and follow-up with a more accurate and more expensive Western blot test for only those units that tested positive. Our cost-effective pooling strategy would enhance current methods by making it possible to accurately estimate the sensitivity and specificity of the initial screening test, and the proportion of defective units that have passed through the system. We also provide a method of estimating the distribution of prevalences for the characteristic throughout the population or subpopulations of interest.

Keywords: AIDS; Bayesian approach; diagnostic testing; Gibbs sampling; HIV testing; prevalence; sensitivity; specificity.
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