Latent class analysis of diagnostic tests for adenovirus,<i>Bordetella pertussis</i>and influenza virus infections in German adults with longer lasting coughs

Sobotzki, Christina; Riffelmann, Marion; Kennerknecht, N.; Hülsse, C; Littmann, Martina; White, Arthur; Kries, Rüdiger von; König, Carl Heinz Wirsing von

doi:10.1017/s0950268815002149

Cited by 4 publications

(5 citation statements)

References 23 publications

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“…In this study, the actual sensitivity and specificity of the viral culture, as determined by Bayesian LCM statistical analysis, was 72.2% and 90.8% respectively, although they are traditionally considered to be 100%. Our analysis is comparable to that of Sobotzki et al, who applied LCM to analyze the true sensitivity of a combined set of tests for pertussis, adenovirus, and influenza A and B in a large population of adult patients with respiratory disease and cough and reported that LCM is a welldocumented and statistically valid tool in the absence of a gold standard test [12].…”

Section: Accuracy Of Viral Culturesupporting

confidence: 77%

“…The absolute accuracy of each diagnostic test was evaluated using Bayesian LCMs [12,15]. In brief, Bayesian LCMs assess the accuracies of various diagnostic tests based on the actual disease status.…”

Section: Statistical Analysis -Bayesian Latent Class Modelmentioning

confidence: 99%

“…Since the sensitivity and specificity of cell culture has been assumed to be perfect (100% sensitivity and specificity), which may not be true, the accuracy of the different diagnostic tests which have been evaluated against the culture may has not been accurately estimated. Studies have demonstrated the utility of Bayesian latent class models (LCM) in estimating the true sensitivity and specificity of alternative tests when the reference test is imperfect [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

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Investigational approach to adenoviral conjunctivitis: comparison of three diagnostic tests using a Bayesian latent class model

Sundaramurthy¹,

Dhodapkar

Kaliaperumal

et al. 2018

J Infect Dev Ctries

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Introduction: Highly contagious adenoviral conjunctivitis represents 15-70% of all conjunctivitis worldwide. Human adenovirus (hAdV) serotypes 3,4,7,8,19 and 37 contributes to 89% of all adenoviral conjunctivitis. Accurate and rapid diagnosis of adenoviral infections at serotype level could prevent misdiagnosis, spread of disease, unnecessary antibiotic use and increased treatment costs. Methodology: Sixty-two suspected viral conjunctivitis cases were recruited from November2013-January2015. Swabs collected from inferior palpebral conjunctiva and processed for viral culture (Hep2 cell line), immunofluorescence assay (IFA) and polymerase chain reaction (PCR) (targeting hexon gene). Serotype 3,4,7,8,19 and 37 identification was carried out with an optimized multiplex-PCR (based on hypervariable region of hexon gene) and confirmed by sequence analysis. Bayesian Latent Class Model (LCM) analysis was used to compare sensitivity and specificity of three tests. Results: Adenovirus was detected in 54.8% (34/62) of cases by combination of all three methods. Culture was positive in 23/34 cases (67.6%). PCR and IFA detected adenovirus in 24 (70.5%) and 21 (61.7%) cases respectively. LCM analysis revealed, sensitivity and specificity of PCR, Culture and IFA was 77.8% and 92.4%; 72.2% and 90.8%; 67.6% and 92.9% respectively. Serotyping by multiplex-PCR showed, two cases each were hAdV3 and hAdV4, 18 hAdV8 and two remained unidentified. Results of Multiplex-PCR and sequence analysis showed 100% concordance Conclusion: LCM analysis revealed, PCR is the most appropriate method for identification. Multiplex-PCR is a simple and rapid method (serotypes identification within two days); owing its short turnaround time and accuracy, it can be used as a diagnostic tool for surveillance of adenoviral keratoconjunctivitis.

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Section: Accuracy Of Viral Culturesupporting

confidence: 77%

Section: Statistical Analysis -Bayesian Latent Class Modelmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Investigational approach to adenoviral conjunctivitis: comparison of three diagnostic tests using a Bayesian latent class model

Sundaramurthy¹,

Dhodapkar

Kaliaperumal

et al. 2018

J Infect Dev Ctries

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“…LCA has been used extensively in the social sciences but is now increasingly used to examine diagnostic tests in medicine. 11 It uses the observed patterns of test results to calculate the prevalence of the underlying condition, which otherwise cannot be directly observed, as well as the sensitivity and specificity of the tests. We used LCA to understand the three available tests for LTBI among a cohort of persons at high risk for LTBI.…”

Section: Introductionmentioning

confidence: 99%

Evaluating latent tuberculosis infection diagnostics using latent class analysis

Stout

et al. 2018

Thorax

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“…Diagnostic serology is relevant for pertussis and mycoplasma infections [13,26], and in 9 patients with IgM antibodies to M. pneumoniae, we assumed a polyclonal response to multiple other antigens. Although viral serology is sometimes regarded as obsolete, we have recently shown that applying latent class analysis for validating diagnostic methods in the absence of a Bgold standard,^single-sample viral serology may identify additional cases [27].…”

Section: Discussionmentioning

confidence: 99%

Long-lasting cough in an adult German population: incidence, symptoms, and related pathogens

Weinberger

Riffelmann

Kennerknecht

et al. 2018

Eur J Clin Microbiol Infect Dis

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Studies of the incidence of pertussis in adults have shown that it accounts for only 5-15% cases of prolonged coughing. We assessed the burden of suffering related to prolonged coughing and tried to identify further causative agents. Based on a sentinel study with 35 general practitioners in two German cities (Krefeld, Rostock), with 3,946 patients fulfilling the inclusion criteria, we estimated the incidence of prolonged coughing in adults. In 975 of these outpatients, PCR and/or serology for adenovirus, Bordetella pertussis and B. parapertussis, human metapneumovirus, influenza virus A and rhinovirus, parainfluenza virus, Mycoplasma pneumonia, and respiratory syncytial virus (RSV) were performed. Treatment data were extracted for a subgroup of 138 patients. Descriptive statistics, including Kaplan-Maier curves were generated. Yearly incidence ranged between 1.4 and 2.1% per population in the two cities. Adult patients sought medical attention only after a median of 3 weeks of coughing. Irrespective of smoking and unrelated to the identified pathogens, the median duration of coughing was 6 weeks, with an interquartile range of 4-11 weeks. In 48.3% of patients, possible pathogens were identified, among which adenovirus (15.1%), RSV (7.5%), B. pertussis (5.6%), and influenza viruses (4.0%) were most often found. Symptoms were not indicative of a specific agent and a total of 64% of patients received antibiotics. Prolonged adult coughing requiring medical attention prompts substantial healthcare use. Apart from B. pertussis, a broad range of pathogens was associated with the symptoms. However, patients sought medical attention too late to guide efficacious therapeutic interventions using the diagnostic tests.

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Latent class analysis of diagnostic tests for adenovirus,Bordetella pertussisand influenza virus infections in German adults with longer lasting coughs

Cited by 4 publications

References 23 publications

Investigational approach to adenoviral conjunctivitis: comparison of three diagnostic tests using a Bayesian latent class model

Investigational approach to adenoviral conjunctivitis: comparison of three diagnostic tests using a Bayesian latent class model

Evaluating latent tuberculosis infection diagnostics using latent class analysis

Long-lasting cough in an adult German population: incidence, symptoms, and related pathogens

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