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Potential for Bias in Prevalence Estimates when Not Accounting for Test Sensitivity and Specificity: A Systematic Review of COVID-19 Seroprevalence Studies

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Název: Potential for Bias in Prevalence Estimates when Not Accounting for Test Sensitivity and Specificity: A Systematic Review of COVID-19 Seroprevalence Studies
Autoři: Sarah R. Haile, David Kronthaler
Zdroj: Int J Public Health
International Journal of Public Health, Vol 70 (2025)
Informace o vydavateli: Frontiers Media SA, 2025.
Rok vydání: 2025
Témata: diagnostic tests, seroprevalence, Rogen-Gladen, Public Health Archive, prevalence, statistical methods, bayesian, Public aspects of medicine, RA1-1270
Popis: ObjectivesThe COVID-19 pandemic has led to many studies of seroprevalence. A number of methods exist in the statistical literature to correctly estimate disease prevalence or seroprevalence in the presence of diagnostic test misclassification, but these methods seem to be not routinely used in the public health literature. We aimed to examine how widespread the problem is in recent publications, and to quantify the magnitude of bias introduced when correct methods are not used.MethodsA systematic review was performed to estimate how often public health researchers accounted for diagnostic test performance in estimates of seroprevalence.ResultsOf the seroprevalence studies sampled, 77% (95% CI 72%–82%) failed to account for sensitivity and specificity. In high impact journals, 72% did not correct for test characteristics, and 34% did not report sensitivity or specificity. The most common type of correction was the Rogen-Gladen formula (57%, 45%–69%), followed by Bayesian approaches (32%, 21%–44%). Rates of correction increased slightly over time, but type of correction did not change.ConclusionResearchers conducting studies of prevalence should report sensitivity and specificity of the diagnostic test and correctly account for these characteristics.
Druh dokumentu: Article
Other literature type
ISSN: 1661-8564
DOI: 10.3389/ijph.2025.1608343
Přístupová URL adresa: https://doaj.org/article/07b6d3488ce9440b9e8aa7be9a291cb0
Rights: CC BY
Přístupové číslo: edsair.doi.dedup.....35e260d7c49aaf7fcc3489ef7c66d15b
Databáze: OpenAIRE
Popis
Abstrakt:ObjectivesThe COVID-19 pandemic has led to many studies of seroprevalence. A number of methods exist in the statistical literature to correctly estimate disease prevalence or seroprevalence in the presence of diagnostic test misclassification, but these methods seem to be not routinely used in the public health literature. We aimed to examine how widespread the problem is in recent publications, and to quantify the magnitude of bias introduced when correct methods are not used.MethodsA systematic review was performed to estimate how often public health researchers accounted for diagnostic test performance in estimates of seroprevalence.ResultsOf the seroprevalence studies sampled, 77% (95% CI 72%–82%) failed to account for sensitivity and specificity. In high impact journals, 72% did not correct for test characteristics, and 34% did not report sensitivity or specificity. The most common type of correction was the Rogen-Gladen formula (57%, 45%–69%), followed by Bayesian approaches (32%, 21%–44%). Rates of correction increased slightly over time, but type of correction did not change.ConclusionResearchers conducting studies of prevalence should report sensitivity and specificity of the diagnostic test and correctly account for these characteristics.
ISSN:16618564
DOI:10.3389/ijph.2025.1608343