Dorfman pooling enhances SARS-CoV-2 large-scale community testing efficiency

PLOS Glob Public Health. 2023 Apr 18;3(4):e0001793. doi: 10.1371/journal.pgph.0001793. eCollection 2023.

Abstract

PCR-based analysis is the gold standard for detection of SARS-CoV-2 and was used broadly throughout the pandemic. However, heightened demand for testing put strain on diagnostic resources and the adequate amount of PCR-based testing required exceeded existing testing capacity. Pooled testing strategies presented an effective method to increase testing capacity by decreasing the number of tests and resources required for laboratory PCR analysis of SARS-CoV-2. We sought to conduct an analysis of SARS-CoV-2 pooling schemes to determine the sensitivity of various sized Dorfman pooling strategies and evaluate the utility of using such pooling strategies in diagnostic laboratory settings. Overall, a trend of decreasing sensitivity with larger pool sizes was observed, with modest sensitivity losses in the largest pools tested, and high sensitivity in all other pools. Efficiency data was then calculated to determine the optimal Dorfman pool sizes based on test positivity rate. This was correlated with current presumptive test positivity to maximize the number of tests saved, thereby increasing testing capacity and resource efficiency in the community setting. Dorfman pooling methods were evaluated and found to offer a high-throughput solution to SARS-CoV-2 clinical testing that improve resource efficiency in low-resource environments.

Grants and funding

The funding for this project was provided by the Government of Manitoba as part of ongoing clinical testing and surveillance of COVID-19 (DRS). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.