Evaluation of a sequential enzyme immunoassay testing algorithm for Lyme disease demonstrates lack of test independence but high diagnostic specificity

Details

• Alternative Title:
  Diagn Microbiol Infect Dis
• Personal Author:
  Wormser, Gary P. ; Molins, Claudia R. ; Levin, Andrew ; Lipsett, Susan C. ; Nigrovic, Lise E. ; Schriefer, Martin E. ; Branda, John A.
• Description:
  To diagnose Lyme disease, a two-tier testing algorithm is used in which supplemental IgM and IgG immunoblots to detect antibody to Borrelia burgdorferi are reflexively performed if a first-tier assay, such as a whole-cell sonicate-based enzyme immunoassay (WCS EIA), is reactive. Recent data suggest that equal specificity is found by substituting the C6 peptide EIA for immunoblots. In this study using 3956 control sera, we demonstrated that although this two-tier testing algorithm does significantly improve diagnostic specificity compared with each of the EIAs individually, the WCS EIA and the C6 peptide EIA are not independent tests. Therefore, when the C6 peptide EIA is used as the second-tier test, it should be regarded as a supplemental rather than a confirmatory test.
• Subjects:
  Algorithms Antibodies, Bacterial Article Borrelia Burgdorferi C6 Lyme Test Humans Immunoenzyme Techniques Immunoglobulin G Immunoglobulin M Lyme Disease Sensitivity And Specificity Test Independence Two-tier Serology

  More +
• Source:
  Diagn Microbiol Infect Dis. 91(3):217-219
• Pubmed ID:
  29550060
• Pubmed Central ID:
  PMC6519922
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHS/United States
• Volume:
  91
• Issue:
  3
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:e70763cd6cd9917661630f13cbfa49d3c1711f75f53215281daec7a077c46f2a
• Download URL:
  https://stacks.cdc.gov/view/cdc/78530/cdc_78530_DS1.pdf
• File Type:
  [PDF - 49.97 KB ]