Assessment of the sensitivity and specificity of serological (IFAT) and molecular (direct PCR) techniques for diagnosis of leishmaniasis in lagomorphs using a Bayesian approach

Leishmaniasis, caused by Leishmania infantum, is a vector-borne zoonotic disease that is endemic to the Mediterranean basin. The potential of rabbits and hares to serve as competent reservoirs for the disease has recently been demonstrated, although assessment of the importance of their role on disease dynamics is hampered by the absence of quantitative knowledge on the accuracy of diagnostic techniques in these species. A Bayesian latent-class model was used here to estimate the sensitivity and specificity of the Immuno-fluorescence antibody test (IFAT) in serum and a Leishmania-nested PCR (Ln-PCR) in skin for samples collected from 217 rabbits and 70 hares from two different populations in the region of Madrid, Spain. A two-population model, assuming conditional independence between test results and incorporating prior information on the performance of the tests in other animal species obtained from the literature, was used. Two alternative cut-off values were assumed for the interpretation of the IFAT results: 1/50 for conservative and 1/25 for sensitive interpretation. Results suggest that sensitivity and specificity of the IFAT were around 70–80%, whereas the Ln-PCR was highly specific (96%) but had a limited sensitivity (28.9% applying the conservative interpretation and 21.3% with the sensitive one). Prevalence was higher in the rabbit population (50.5% and 72.6%, for the conservative and sensitive interpretation, respectively) than in hares (6.7% and 13.2%). Our results demonstrate that the IFAT may be a useful screening tool for diagnosis of leishmaniasis in rabbits and hares. These results will help to design and implement surveillance programmes in wild species, with the ultimate objective of early detecting and preventing incursions of the disease into domestic and human populations.

Bayesian adaptive estimation of arbitrary points on a psychometric function

Bayesian adaptive methods have been extensively used in psychophysics to estimate the point at which performance on a task attains arbitrary percentage levels, although the statistical properties of these estimators have never been assessed. We used simulation techniques to determine the small-sample properties of Bayesian estimators of arbitrary performance points, specifically addressing the issues of bias and precision as a function of the target percentage level. The study covered three major types of psychophysical task (yes-no detection, 2AFC discrimination and 2AFC detection) and explored the entire range of target performance levels allowed for by each task. Other factors included in the study were the form and parameters of the actual psychometric function Psi, the form and parameters of the model function M assumed in the Bayesian method, and the location of Psi within the parameter space. Our results indicate that Bayesian adaptive methods render unbiased estimators of any arbitrary point on psi only when M=Psi, and otherwise they yield bias whose magnitude can be considerable as the target level moves away from the midpoint of the range of Psi. The standard error of the estimator also increases as the target level approaches extreme values whether or not M=Psi. Contrary to widespread belief, neither the performance level at which bias is null nor that at which standard error is minimal can be predicted by the sweat factor. A closed-form expression nevertheless gives a reasonable fit to data describing the dependence of standard error on number of trials and target level, which allows determination of the number of trials that must be administered to obtain estimates with prescribed precision.