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Latent Class Analysis: Insights about design and analysis of schistosomiasis diagnostic studies

Artemis Koukounari 1 Haziq Jamil 2 Elena Erosheva 3 Clive Shiff 4 Irini Moustaki 5
3 MAASAI - Modèles et algorithmes pour l’intelligence artificielle
CRISAM - Inria Sophia Antipolis - Méditerranée , UNS - Université Nice Sophia Antipolis (... - 2019), JAD - Laboratoire Jean Alexandre Dieudonné, Laboratoire I3S - SPARKS - Scalable and Pervasive softwARe and Knowledge Systems
Abstract : Various global health initiatives are currently advocating the elimination of schistosomiasis within the next decade. Schistosomiasis is a highly debilitating tropical infectious disease with severe burden of morbidity and thus operational research accurately evaluating diagnostics that quantify the epidemic status for guiding effective strategies is essential. Latent class models (LCMs) have been generally considered in epidemiology and in particular in recent schistosomiasis diagnostic studies as a flexible tool for evaluating diagnostics because assessing the true infection status (via a gold standard) is not possible. However, within the biostatistics literature, classical LCM have already been criticised for real-life problems under violation of the conditional independence (CI) assumption and when applied to a small number of diagnostics (i.e. most often 3-5 diagnostic tests). Solutions of relaxing the CI assumption and accounting for zero-inflation, as well as collecting partial gold standard information, have been proposed, offering the potential for more robust model estimates. In the current article, we examined such approaches in the context of schistosomiasis via analysis of two real datasets and extensive simulation studies. Our main conclusions highlighted poor model fit in low prevalence settings and the necessity of collecting partial gold standard information in such settings in order to improve the accuracy and reduce bias of sensitivity and specificity estimates.
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Contributor : Elena Erosheva Connect in order to contact the contributor
Submitted on : Wednesday, January 12, 2022 - 1:16:15 AM
Last modification on : Sunday, May 1, 2022 - 3:14:28 AM
Long-term archiving on: : Wednesday, April 13, 2022 - 6:16:44 PM


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Artemis Koukounari, Haziq Jamil, Elena Erosheva, Clive Shiff, Irini Moustaki. Latent Class Analysis: Insights about design and analysis of schistosomiasis diagnostic studies. PLoS Neglected Tropical Diseases, Public Library of Science, 2021, 15, ⟨10.1371/journal.pntd.0009042⟩. ⟨hal-03522272⟩



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