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Optimal retesting configurations for hierarchical group testing.

ABSTRACT: Hierarchical group testing is widely used to test individuals for diseases. This testing procedure works by first amalgamating individual specimens into groups for testing. Groups testing negatively have their members declared negative. Groups testing positively are subsequently divided into smaller subgroups and are then retested to search for positive individuals. In our paper, we propose a new class of informative retesting procedures for hierarchical group testing that acknowledges heterogeneity among individuals. These procedures identify the optimal number of groups and their sizes at each testing stage in order to minimize the expected number of tests. We apply our proposals in two settings: 1) HIV testing programs that currently use three-stage hierarchical testing and 2) chlamydia and gonorrhea screening practices that currently use individual testing. For both applications, we show that substantial savings can be realized by our new procedures.

SUBMITTER: Black MS

PROVIDER: S-EPMC4495770 | biostudies-literature | 2015 Aug

REPOSITORIES: biostudies-literature

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Optimal retesting configurations for hierarchical group testing.

Black Michael S MS Bilder Christopher R CR Tebbs Joshua M JM

Journal of the Royal Statistical Society. Series C, Applied statistics 20150801 4

Hierarchical group testing is widely used to test individuals for diseases. This testing procedure works by first amalgamating individual specimens into groups for testing. Groups testing negatively have their members declared negative. Groups testing positively are subsequently divided into smaller subgroups and are then retested to search for positive individuals. In our paper, we propose a new class of informative retesting procedures for hierarchical group testing that acknowledges heterogen ...[more]

PMID: 26166904

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Project description:As economic woes of the COVID-19 pandemic deepen, strategies are being formulated to avoid the need for prolonged stay-at-home orders, while implementing risk-based quarantine, testing, contact tracing and surveillance protocols. Given limited resources and the significant economic, public health, and operational challenges of the current 14-day quarantine recommendation, it is vital to understand if shorter but equally effective quarantine and testing strategies can be deployed. To quantify the probability of post-quarantine transmission upon isolation of a positive test, we developed a mathematical model in which we varied quarantine duration and the timing of molecular tests for three scenarios of entry into quarantine. Specifically, we consider travel quarantine, quarantine of traced contacts with an unknown time if infection, and quarantine of cases with a known time of exposure. With a one-day delay between test and result, we found that testing on exit (or entry and exit) can reduce the duration of a 14-day quarantine by 50%, while testing on entry shortened quarantine by at most one day. Testing on exit more effectively reduces post-quarantine transmission than testing upon entry. Furthermore, we identified the optimal testing date within quarantines of varying duration, finding that testing on exit was most effective for quarantines lasting up to seven days. As a real-world validation of these principles, we analyzed the results of 4,040 SARS CoV-2 RT-PCR tests administered to offshore oil rig employees. Among the 47 positives obtained with a testing on entry and exit strategy, 16 cases that previously tested negative at entry were identified, with no further cases detected among employees following quarantine exit. Moreover, this strategy successfully prevented an expected nine offshore transmission events stemming from cases who had tested negative on the entry test, each one a serious concern for initiating rapid spread and a disabling outbreak in the close quarters of an offshore rig. This successful outcome highlights that appropriately timed testing can make shorter quarantines more effective, thereby minimizing economic impacts, disruptions to operational integrity, and COVID-related public health risks.

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Optimal retesting configurations for hierarchical group testing.

Publications

Optimal retesting configurations for hierarchical group testing.

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