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

Abstract

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.