On the estimation of the incidence and prevalence in two-phase longitudinal sampling design

Abstract

SUMMARY Two-phase sampling design is a common practice in many medical studies. Generally, the first-phase classification is fallible but relatively cheap, while the accurate second phase state-of-the-art medical diagnosis is complex and rather expensive to perform. When constructed efficiently it offers great potential for higher true case detection as well as for higher precision at a limited cost. In this article, we consider epidemiological studies with two-phase sampling design. However, instead of a single two-phase study, we consider a scenario where a series of two-phase studies are done in a longitudinal fashion on a cohort of interest. Another major design issue is non-curable pattern of certain disease (e.g. Dementia, Alzheimer’s etc.). Thus often the identified disease positive subjects are removed from the original population under observation, as they require clinical attention, which is quite different from the yet unidentified group. In this article, we motivated our methodology development from two real-life studies. We consider efficient and simultaneous estimation of prevalence as well incidence at multiple time points from a sampling design-based approach. We have explicitly shown the benefit of our developed methodology for an elderly population with significant burden of home-health care usage and at the high risk of major depressive disorder.