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Evaluating the sensitivity and predictive value of tests of recent infection: toxoplasmosis in pregnancy

Published online by Cambridge University Press:  15 May 2009

A. E. Ades
Affiliation:
Epidemiology and Biostatistics Unit, Institute of Child Health, 30 Guilford Street, London WC1N1EH
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Summary

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The diagnosis of maternal infection in early pregnancy depends on tests which are sensitive to recent infection, such as specific IgM. Two types of test are considered: those where the response persists for a period following infection and then declines, such as IgM. and those whose response increases with time since infection, such as IgG-avidity. However, individuals vary in their response to infection, and it may not always be possible to determine whether an infection occurred during pregnancy or before it. Mathematical methods are developed to evaluate the performance of these tests, and are applied to the diagnosis of toxoplasmosis in pregnancy. It is shown that, based on existing information, tests of recent infection are unlikely to be both sensitive and predictive. More data on these tests are required, before they can be reliably used to determine whether infection has occurred during pregnancy or before it.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1991

References

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