Using group testing in a two-phase epidemiologic design to identify the effects of a large number of antibody reactions on disease risk

BMC Med Res Methodol. 2022 Dec 16;22(1):324. doi: 10.1186/s12874-022-01798-0.

Abstract

Background: The role of immunological responses to exposed bacteria on disease incidence is increasingly under investigation. With many bacterial species, and many potential antibody reactions to a particular species, the large number of assays required for this type of discovery can make it prohibitively expensive. We propose a two-phase group testing design to more efficiently screen numerous antibody effects in a case-control setting.

Methods: Phase 1 uses group testing to select antibodies that are differentially expressed between cases and controls. The selected antibodies go on to Phase 2 individual testing.

Results: We evaluate the two-phase group testing design through simulations and example data and find that it substantially reduces the number of assays required relative to standard case-control and group testing designs, while maintaining similar statistical properties.

Conclusion: The proposed two-phase group testing design can dramatically reduce the number of assays required, while providing comparable results to a case-control design.

Keywords: Case-control studies; Epidemiologic design; Group Testing; Prevalence estimation.