Continuous-data diagnostic tests for paratuberculosis as a multistage disease

Nils Toft, S. S. Nielsen, E. Jørgensen

Research output: Contribution to journalJournal articleResearchpeer-review


We devised a general method for interpretation of multistage diseases using continuous-data diagnostic tests. As an example, we used paratuberculosis as a multistage infection with 2 stages of infection as well as a noninfected state. Using data from a Danish research project, a fecal culture testing scheme was linked to an indirect ELISA and adjusted for covariates ( parity, age at first calving, and days in milk). We used the log-transformed optical densities in a Bayesian network to obtain the probabilities for each of the 3 infection stages for a given optical density ( adjusted for covariates). The strength of this approach was that the uncertainty associated with a test was imposed directly on the individual test result rather than aggregated into the population-based measures of test properties (i.e., sensitivity and specificity).
Original languageEnglish
JournalJournal of Dairy Science
Issue number11
Pages (from-to)3923-3931
Number of pages9
Publication statusPublished - 2005
Externally publishedYes

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