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Augmented cross-sectional studies with abbreviated follow-up for estimating HIV incidence.
- Source :
-
Biometrics [Biometrics] 2012 Mar; Vol. 68 (1), pp. 62-74. Date of Electronic Publication: 2011 Jun 13. - Publication Year :
- 2012
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Abstract
- Cross-sectional HIV incidence estimation based on a sensitive and less-sensitive test offers great advantages over the traditional cohort study. However, its use has been limited due to concerns about the false negative rate of the less-sensitive test, reflecting the phenomenon that some subjects may remain negative permanently on the less-sensitive test. Wang and Lagakos (2010, Biometrics 66, 864-874) propose an augmented cross-sectional design that provides one way to estimate the size of the infected population who remain negative permanently and subsequently incorporate this information in the cross-sectional incidence estimator. In an augmented cross-sectional study, subjects who test negative on the less-sensitive test in the cross-sectional survey are followed forward for transition into the nonrecent state, at which time they would test positive on the less-sensitive test. However, considerable uncertainty exists regarding the appropriate length of follow-up and the size of the infected population who remain nonreactive permanently to the less-sensitive test. In this article, we assess the impact of varying follow-up time on the resulting incidence estimators from an augmented cross-sectional study, evaluate the robustness of cross-sectional estimators to assumptions about the existence and the size of the subpopulation who will remain negative permanently, and propose a new estimator based on abbreviated follow-up time (AF). Compared to the original estimator from an augmented cross-sectional study, the AF estimator allows shorter follow-up time and does not require estimation of the mean window period, defined as the average time between detectability of HIV infection with the sensitive and less-sensitive tests. It is shown to perform well in a wide range of settings. We discuss when the AF estimator would be expected to perform well and offer design considerations for an augmented cross-sectional study with abbreviated follow-up.<br /> (© 2011, The International Biometric Society.)
Details
- Language :
- English
- ISSN :
- 1541-0420
- Volume :
- 68
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Biometrics
- Publication Type :
- Academic Journal
- Accession number :
- 21668904
- Full Text :
- https://doi.org/10.1111/j.1541-0420.2011.01632.x