Diagnostic sensitivity 2026-10-20
Diagnostic sensitivity is the probability that a test is positive in a person who has the target condition. For past-infection assays, the target is prior infection rather than current disease. Estimate it from suitable independently characterized positive samples; using the same assay to define truth would make the assessment circular.
Assume a constant annual force of infection across ages and calendar years. For independent sampled people with ages and binary results , fitApplying the complementary log-log link givesTherefore fit a binomial regression with the complementary log-log link, an intercept, and as an offset with coefficient fixed at one. Age is measured in years. An ordinary freely fitted coefficient of age, or even a freely fitted coefficient of , would describe a different exposure model. The annual force of infection estimate isAn infection-naive person's one-year infection probability is , which is approximately only when that rate is small.
The log-likelihood being maximized is, apart from constants,A confidence interval for can be exponentiated to give a positive interval for . For groups of people at a common age , use with the same offset. If an age band is broad, use individual ages or average over the band's age distribution instead of treating its midpoint as exact. No numerical estimate is possible without the survey observations.
The biological interpretation assumes that immunoglobulin G positivity records previous infection, persists over the relevant ages, and is not substantially produced by maternal antibodies or vaccination. These are conditions to check, rather than conclusions from the fitted curve. Use known-positive and known-negative serum controls to assess the assay threshold, and validate specificity against relevant other infections. Cross-reactive antibodies to other flaviviruses can produce positive dengue virus serology, so a positive result need not be a marker specific to dengue virus exposure.[ref]
Serologic Tests for Dengue Virus by the Centers for Disease Control and Prevention. IgG Tests: persistence after previous exposure and cross-reactivity with other flaviviruses
If independently established assay diagnostic sensitivity and diagnostic specificity are and , the observed positive probability isUse that observation model in the binomial likelihood; it is generally no longer the simple intercept-plus-offset complementary log-log link fit. With only the stated survey, one cannot freely estimate , , antibody loss and an arbitrary infection history simultaneously. A single binary result also does not identify how many subsequent infections a person has experienced.
Recall (classification) 2026-10-20
The fraction of genuinely positive cases recovered by a classifier. The denominator counts all reference-positive cases, , rather than positive predictions. In a diagnostic setting this is diagnostic sensitivity.
Seroprevalence 2026-10-20
Seroprevalence is the proportion of a specified population with a positive result for a specified antibody assay. Its biological interpretation depends on assay diagnostic sensitivity, diagnostic specificity and the persistence and origin of the measured antibodies. It is not itself the incidence rate of new infection.