Inferring lung cancer risk factor patterns through joint Bayesian spatio-temporal analysis

Background: Preventing risk factor exposure is vital to reduce the high burden from lung cancer. The leading risk factor for developing lung cancer is tobacco smoking. In Australia, despite apparent success in reducing smoking prevalence, there is limited information on small area patterns and small area temporal trends. We sought to estimate spatio-temporal patterns for lung cancer risk factors using routinely collected population-based cancer data. Methods: The analysis used a Bayesian shared component spatio-temporal model, with male and female lung cancer included separately. The shared component reflected exposure to lung cancer risk factors, and was modelled over 477 statistical local areas (SLAs) and 15 years in Queensland, Australia. Analyses were also run adjusting for area-level socioeconomic disadvantage, Indigenous population composition, or remoteness. Results: Strong spatial patterns were observed in the underlying risk factor exposure for both males (median Relative Risk (RR) across SLAs compared to the Queensland average ranged from 0.48-2.00) and females (median RR range across SLAs 0.53-1.80), with high exposure observed in many remote areas. Strong temporal trends were also observed. Males showed a decrease in the underlying risk across time, while females showed an increase followed by a decrease in the final two years. These patterns were largely consistent across each SLA. The high underlying risk estimates observed among disadvantaged, remote and indigenous areas decreased after adjustment, particularly among females. Conclusion: The modelled underlying exposure appeared to reflect previous smoking prevalence, with a lag period of around 30 years, consistent with the time taken to develop lung cancer. The consistent temporal trends in lung cancer risk factors across small areas support the hypothesis that past interventions have been equally effective across the state. However, this also means that spatial inequalities have remained unaddressed, highlighting the potential for future interventions, particularly among remote areas.

Errors in the knee joint forces and moments during gait depending on the foot and knee prosthetic components

Background Previously studies showed that inverse dynamics based on motion analysis and force-plate is inaccurate compared to direct measurements for individuals with transfemoral amputation (TFA). Indeed, direct measurements can appropriately take into account the absorption at the prosthetic foot and the resistance at the prosthetic knee. [1-3] However, these studies involved only a passive prosthetic knee. Aim The objective of the present study was to investigate if different types of prosthetic feet and knees can exhibit different levels of error in the knee joint forces and moments. Method Three trials of walking at self-selected speed were analysed for 9 TFAs (7 males and 2 females, 47±9 years old, 1.76±0.1 m 79±17 kg) with a motion analysis system (Qualisys, Goteborg, Sweden), force plates (Kitsler, Winterthur, Switzerland) and a multi-axial transducer (JR3, Woodland, USA) mounted above the prosthetic knee [1-17]. TFAs were all fitted with an osseointegrated implant system. The prostheses included different type of foot (N=5) and knee (N=3) components. The root mean square errors (RMSE) between direct measurements and the knee joint forces and moments estimated by inverse dynamics were computed for stance and swing phases of gait and expressed as a percentage of the measured amplitudes. A one-way Kruskal-Wallis ANOVA was performed (Statgraphics, Levallois-Perret, France) to analyse the effects of the prosthetic components on the RMSEs. Cross-effects and post-hoc tests were not analysed in this study. Results A significant effect (*) was found for the type of prosthetic foot on anterior-posterior force during swing (p=0.016), lateral-medial force during stance (p=0.009), adduction-abduction moment during stance (p=0.038), internal-external rotation moment during stance (p=0.014) and during swing (p=0.006), and flexion-extension moment during stance (p = 0.035). A significant effect (#) was found for the type of prosthetic knee on anterior-posterior force during swing (p=0.018) and adduction-abduction moment during stance (p=0.035). Discussion & Conclusion The RMSEs were larger during swing than during stance. It is because the errors on accelerations (as derived from motion analysis) become substantial with respect to the external loads. Thus, inverse dynamics during swing should be analysed with caution because the mean RMSEs are close to 50%. Conversely, there were fewer effects of the prosthetic components on RMSE during swing than during stance and, accordingly, fewer effects due to knees than feet. Thus, inverse dynamics during stance should be used with caution for comparison of different prosthetic components.

Conditional Probability-Based Significance Tests for Sequential Patterns in Multineuronal Spike Trains

We consider the problem of detecting statistically significant sequential patterns in multineuronal spike trains. These patterns are characterized by ordered sequences of spikes from different neurons with specific delays between spikes. We have previously proposed a data-mining scheme to efficiently discover such patterns, which occur often enough in the data. Here we propose a method to determine the statistical significance of such repeating patterns. The novelty of our approach is that we use a compound null hypothesis that not only includes models of independent neurons but also models where neurons have weak dependencies. The strength of interaction among the neurons is represented in terms of certain pair-wise conditional probabilities. We specify our null hypothesis by putting an upper bound on all such conditional probabilities. We construct a probabilistic model that captures the counting process and use this to derive a test of significance for rejecting such a compound null hypothesis. The structure of our null hypothesis also allows us to rank-order different significant patterns. We illustrate the effectiveness of our approach using spike trains generated with a simulator.

The Power of Bootstrap Tests of Cointegration Rank with Financial Time Series

Bootstrap likelihood ratio tests of cointegration rank are commonly used because they tend to have rejection probabilities that are closer to the nominal level than the rejection probabilities of the correspond- ing asymptotic tests. The e¤ect of bootstrapping the test on its power is largely unknown. We show that a new computationally inexpensive procedure can be applied to the estimation of the power function of the bootstrap test of cointegration rank. The bootstrap test is found to have a power function close to that of the level-adjusted asymp- totic test. The bootstrap test estimates the level-adjusted power of the asymptotic test highly accurately. The bootstrap test may have low power to reject the null hypothesis of cointegration rank zero, or underestimate the cointegration rank. An empirical application to Euribor interest rates is provided as an illustration of the findings.

Tensile flow behaviour of 2.25Cr-1Mo ferritic steel base metal and simulated heat affected zone structures of 2.25Cr-1Mo weld joint

Tensile tests in the temperature range 298 to 873 K have been performed on 2.25Cr-1Mo base metal and simulated heat affected zone (HAZ) structures of its weld joint, namely coarse grain bainite, fine grain bainite and intercritical structure. Tensile flow behaviour of all the microstructural conditions could be adequately described by the Hollomon equation (sigma = K-1 epsilon(n1)) at higher (> 623 K) temperatures. Deviation from the Hollomon equation was observed at low strains and lower (< 623 K) temperatures. The Ludwigson modification of Hollomon's equation, sigma = K-1 epsilon(n1) + exp (K-2 + n(2) epsilon), was found to describe the flow curve. In general, the flow parameters n(1), K-1, n(2) and K-2 were found to decrease with increase in temperature except in the intermediate temperature range (423 to 623 K). Peaks/plateaus were observed in their variation with temperature in the intermediate temperature range coinciding with the occurrence of serrated flow in the load-elongation curve. The n(1) Value increased and the K-1 value decreased with the type of microstructure in the order: coarse grain bainite, fine grain bainite, base metal and intercritical structure. The variation of nl with microstructure has been rationalized on the basis of mean free path (MFP) of dislocations which is directly related to the inter-particle spacing. Larger MFP of dislocations lead to higher strain hardening exponents n(1).

Efficient methods for empirical tests of behavioral economics theories in laboratory and field experiments

In the quest for a descriptive theory of decision-making, the rational actor model in economics imposes rather unrealistic expectations and abilities on human decision makers. The further we move from idealized scenarios, such as perfectly competitive markets, and ambitiously extend the reach of the theory to describe everyday decision making situations, the less sense these assumptions make. Behavioural economics has instead proposed models based on assumptions that are more psychologically realistic, with the aim of gaining more precision and descriptive power. Increased psychological realism, however, comes at the cost of a greater number of parameters and model complexity. Now there are a plethora of models, based on different assumptions, applicable in differing contextual settings, and selecting the right model to use tends to be an ad-hoc process. In this thesis, we develop optimal experimental design methods and evaluate different behavioral theories against evidence from lab and field experiments.

We look at evidence from controlled laboratory experiments. Subjects are presented with choices between monetary gambles or lotteries. Different decision-making theories evaluate the choices differently and would make distinct predictions about the subjects' choices. Theories whose predictions are inconsistent with the actual choices can be systematically eliminated. Behavioural theories can have multiple parameters requiring complex experimental designs with a very large number of possible choice tests. This imposes computational and economic constraints on using classical experimental design methods. We develop a methodology of adaptive tests: Bayesian Rapid Optimal Adaptive Designs (BROAD) that sequentially chooses the "most informative" test at each stage, and based on the response updates its posterior beliefs over the theories, which informs the next most informative test to run. BROAD utilizes the Equivalent Class Edge Cutting (EC²) criteria to select tests. We prove that the EC² criteria is adaptively submodular, which allows us to prove theoretical guarantees against the Bayes-optimal testing sequence even in the presence of noisy responses. In simulated ground-truth experiments, we find that the EC² criteria recovers the true hypotheses with significantly fewer tests than more widely used criteria such as Information Gain and Generalized Binary Search. We show, theoretically as well as experimentally, that surprisingly these popular criteria can perform poorly in the presence of noise, or subject errors. Furthermore, we use the adaptive submodular property of EC² to implement an accelerated greedy version of BROAD which leads to orders of magnitude speedup over other methods.

We use BROAD to perform two experiments. First, we compare the main classes of theories for decision-making under risk, namely: expected value, prospect theory, constant relative risk aversion (CRRA) and moments models. Subjects are given an initial endowment, and sequentially presented choices between two lotteries, with the possibility of losses. The lotteries are selected using BROAD, and 57 subjects from Caltech and UCLA are incentivized by randomly realizing one of the lotteries chosen. Aggregate posterior probabilities over the theories show limited evidence in favour of CRRA and moments' models. Classifying the subjects into types showed that most subjects are described by prospect theory, followed by expected value. Adaptive experimental design raises the possibility that subjects could engage in strategic manipulation, i.e. subjects could mask their true preferences and choose differently in order to obtain more favourable tests in later rounds thereby increasing their payoffs. We pay close attention to this problem; strategic manipulation is ruled out since it is infeasible in practice, and also since we do not find any signatures of it in our data.

In the second experiment, we compare the main theories of time preference: exponential discounting, hyperbolic discounting, "present bias" models: quasi-hyperbolic (α, β) discounting and fixed cost discounting, and generalized-hyperbolic discounting. 40 subjects from UCLA were given choices between 2 options: a smaller but more immediate payoff versus a larger but later payoff. We found very limited evidence for present bias models and hyperbolic discounting, and most subjects were classified as generalized hyperbolic discounting types, followed by exponential discounting.

In these models the passage of time is linear. We instead consider a psychological model where the perception of time is subjective. We prove that when the biological (subjective) time is positively dependent, it gives rise to hyperbolic discounting and temporal choice inconsistency.

We also test the predictions of behavioral theories in the "wild". We pay attention to prospect theory, which emerged as the dominant theory in our lab experiments of risky choice. Loss aversion and reference dependence predicts that consumers will behave in a uniquely distinct way than the standard rational model predicts. Specifically, loss aversion predicts that when an item is being offered at a discount, the demand for it will be greater than that explained by its price elasticity. Even more importantly, when the item is no longer discounted, demand for its close substitute would increase excessively. We tested this prediction using a discrete choice model with loss-averse utility function on data from a large eCommerce retailer. Not only did we identify loss aversion, but we also found that the effect decreased with consumers' experience. We outline the policy implications that consumer loss aversion entails, and strategies for competitive pricing.

In future work, BROAD can be widely applicable for testing different behavioural models, e.g. in social preference and game theory, and in different contextual settings. Additional measurements beyond choice data, including biological measurements such as skin conductance, can be used to more rapidly eliminate hypothesis and speed up model comparison. Discrete choice models also provide a framework for testing behavioural models with field data, and encourage combined lab-field experiments.

Joint Anglo-Soviet biological surveillance exercise on River Dnieper

As one part of an on-going programme concerned with environmental protection as provided for under the terms of a UK/USSR Joint Environmental Protection Agreement signed in London, 21 May 1974, a seminar — ”The elaboration of the scientific basis for monitoring the quality of surface water by hydrobiological indices” was held at Valdai in Russia 12—14 July, 1976. As a continuation of this theme it was agreed that delegations of hydrobiologists from each side should carry out reciprocal visits to carry out comparative field tests on selected systems of biological surveillance in use in the respective countries. In May 1978 a team of British hydrobiologists visited the USSR, under the auspices of the Department of Environment, to carry out joint exercises on the River Dnieper and some tributaries. This paper reports the results of selected methods used by the British side when applied to the conditions found in the River Dnieper.

Joint modelling of voicing label and continuous F0 for HMM based speech synthesis

Fundamental frequency, or F0 is critical for high quality speech synthesis in HMM based speech synthesis. Traditionally, F0 values are considered to depend on a binary voicing decision such that they are continuous in voiced regions and undefined in unvoiced regions. Multi-space distribution HMM (MSDHMM) has been used for modelling the discontinuous F0. Recently, a continuous F0 modelling framework has been proposed and shown to be effective, where continuous F0 observations are assumed to always exist and voicing labels are explicitly modelled by an independent stream. In this paper, a refined continuous F0 modelling approach is proposed. Here, F0 values are assumed to be dependent on voicing labels and both are jointly modelled in a single stream. Due to the enforced dependency, the new method can effectively reduce the voicing classification error. Subjective listening tests also demonstrate that the new approach can yield significant improvements on the naturalness of the synthesised speech. A dynamic random unvoiced F0 generation method is also investigated. Experiments show that it has significant effect on the quality of synthesised speech. © 2011 IEEE.

Neutrality tests using DNA polymorphism from multiple samples

The polymorphism of a gene or a locus is studied with increasing frequency by multiple laboratories or the same group at different times. Such practice results in polymorphism being revealed by different samples at different regions of the locus. Tests of neutrality have been widely conducted for polymorphism data but commonly used statistical tests cannot be applied directly to such data. This article provides a procedure to conduct a neutrality test and details are given for two commonly used tests. Applying the two new tests to the chemokine-receptor gene (CCR5) in humans, we found that the hypothesis that all mutations are selectively neutral cannot explain the observed pattern of DNA polymorphism.

Short- and long-term changes in joint co-contraction associated with motor learning as revealed from surface EMG.

In the field of motor control, two hypotheses have been controversial: whether the brain acquires internal models that generate accurate motor commands, or whether the brain avoids this by using the viscoelasticity of musculoskeletal system. Recent observations on relatively low stiffness during trained movements support the existence of internal models. However, no study has revealed the decrease in viscoelasticity associated with learning that would imply improvement of internal models as well as synergy between the two hypothetical mechanisms. Previously observed decreases in electromyogram (EMG) might have other explanations, such as trajectory modifications that reduce joint torques. To circumvent such complications, we required strict trajectory control and examined only successful trials having identical trajectory and torque profiles. Subjects were asked to perform a hand movement in unison with a target moving along a specified and unusual trajectory, with shoulder and elbow in the horizontal plane at the shoulder level. To evaluate joint viscoelasticity during the learning of this movement, we proposed an index of muscle co-contraction around the joint (IMCJ). The IMCJ was defined as the summation of the absolute values of antagonistic muscle torques around the joint and computed from the linear relation between surface EMG and joint torque. The IMCJ during isometric contraction, as well as during movements, was confirmed to correlate well with joint stiffness estimated using the conventional method, i.e., applying mechanical perturbations. Accordingly, the IMCJ during the learning of the movement was computed for each joint of each trial using estimated EMG-torque relationship. At the same time, the performance error for each trial was specified as the root mean square of the distance between the target and hand at each time step over the entire trajectory. The time-series data of IMCJ and performance error were decomposed into long-term components that showed decreases in IMCJ in accordance with learning with little change in the trajectory and short-term interactions between the IMCJ and performance error. A cross-correlation analysis and impulse responses both suggested that higher IMCJs follow poor performances, and lower IMCJs follow good performances within a few successive trials. Our results support the hypothesis that viscoelasticity contributes more when internal models are inaccurate, while internal models contribute more after the completion of learning. It is demonstrated that the CNS regulates viscoelasticity on a short- and long-term basis depending on performance error and finally acquires smooth and accurate movements while maintaining stability during the entire learning process.

Behaviour of cast-iron tunnel segmental joint from the 3D FE analyses and development of a new bolt-spring model

The behaviour of cast-iron tunnel segments used in London Underground tunnels was investigated using the 3-D finite element (FE) method. A numerical model of the structural details of cast-iron segmental joints such as bolts, panel and flanges was developed and its performance was validated against a set of full-scale tests. Using the verified model, the influence of structural features such as caulking groove and bolt pretension was examined for both rotational and shear loading conditions. Since such detailed modelling of bolts increases the computational time when a full scale segmental tunnel is analysed, it is proposed to replace the bolt model to a set of spring models. The parameters for the bolt-spring models, which consider the geometry and material properties of the bolt, are proposed. The performance of the combined bolt-spring and solid segmental models are evaluated against a more conventional shell-spring model. © 2014 Elsevier Ltd.

基于窗口精细结构描述的岩体质量评价及力学参数综合优选

This thesis bases on horizontal research project “The research about the fine structure and mechanical parameters of abutment jointed rock mass of high arch dam on Jinping Ⅰ Hydropower Station, Yalong River” and “The research about the fine structure and mechanical parameters of the columnar basalt rock mass on Baihetan Hydropower Station, Jinsha River”. A rounded system about the fine structure description and rock mass classification is established. This research mainly contains six aspects as follow: (1) Methods about fine structure description of the window rock mass; (2) The window rock mass classification about the fine structure; (3) Model test study of intermittent joints; (4) Window rock mass strength theory; (5) Numerical experimentations about window rock mass; (6) The multi-source fusion of mechanical parameters based on Bayes principle. Variation of intact rock strength and joint conditions with the weathering and relaxation degree is studied through the description of window rock mass. And four principal parameters: intact rock point load strength, integration degree of window rock mass, joint conditions, and groundwater condition is selected to assess the window rock mass. Window rock mass is classified into three types using the results of window rock mass fine structure description combined with joints develop model. Scores about intact rock strength, integrality condition, divisional plane condition and groundwater conditions are given based on window rock mass fine structure description. Then quality evaluation about two different types of rock mass: general joint structure and columnar jointing structure are carried out to use this window rock mass classification system. Application results show that the window rock mass classification system is effective and applicable. Aimed at structural features of window structure of “the rock mass damaged by recessive fracture”, model tests and numerical models are designed about intermittent joints. By conducting model tests we get shear strength under different normal stress in integrated samples, through samples and intermittent joints samples. Also, the changing trends of shear strength in various connectivity rates are analyzed. We numerically simulate the entire process of direct shear tests by using PFC2D. In order to tally the stress-strain curve of numerical simulation with experimental tests about both integrated samples and through samples, we adjust mechanical factors between particles. Through adopting the same particle geometric parameter, the numerical sample of intermittent joints in different connective condition is re-built. At the same time, we endow the rock bridges and joints in testing samples with the fixed particle contacting parameters, and conduct a series of direct shear tests. Then the destructive process and mechanical parameters in both micro-prospective and macro-prospective are obtained. By synthesizing the results of numerical and sample tests and analyzing the evolutionary changes of stress and strain on intermittent joints plane, we conclude that the centralization of compressive stress on rock bridges increase the shear strength of it. We discuss the destructive mechanics of intermittent joints rock under direct shear condition, meanwhile, divide the whole shear process into five phases, which are elasticity phase, fracture initiation phase, peak value phase, after-peak phase and residual phase. In development of strength theory, the shear strength mechanisms of joint and rock bridge are analyzed respectively. In order to apply the deducted formulation conveniently in the real projects, a relationship between these formulations and Mohr-Coulomb hypothesis is built up. Some sets of numerical simulation methods, i.e. the distinct element method (UDEC) based on in-situ geology mapping are developed and introduced. The working methods about determining mechanical parameters of intact rock and joints in numerical model are studied. The operation process and analysis results are demonstrated detailed from the research on parameters of rock mass based on numerical test in the Jinping Ⅰ Hydropower Station and Baihetan Hydropower Station. By comparison，the advantages and disadvantages are discussed. Results about numerical simulation study show that we can get the shear strength mechanical parameters by changing the load conditions. The multi-source rock mass mechanical parameters can be fused by the Bayes theory, which are test value, empirical value and theoretical value. Then the value range and its confidence probability of different rock mass grade are induced and these data supports the reliability design.

基于精细结构描述及数值试验的断续节理岩体力学参数智能选取

Evaluating the mechanical properties of rock masses is the base of rock engineering design and construction. It has great influence on the safety and cost of rock project. The recognition is inevitable consequence of new engineering activities in rock, including high-rise building, super bridge, complex underground installations, hydraulic project and etc. During the constructions, lots of engineering accidents happened, which bring great damage to people. According to the investigation, many failures are due to choosing improper mechanical properties. ‘Can’t give the proper properties’ becomes one of big problems for theoretic analysis and numerical simulation. Selecting the properties reasonably and effectively is very significant for the planning, design and construction of rock engineering works. A multiple method based on site investigation, theoretic analysis, model test, numerical test and back analysis by artificial neural network is conducted to determine and optimize the mechanical properties for engineering design. The following outcomes are obtained: (1) Mapping of the rock mass structure Detailed geological investigation is the soul of the fine structure description. Based on statistical window，geological sketch and digital photography，a new method for rock mass fine structure in-situ mapping is developed. It has already been taken into practice and received good comments in Baihetan Hydropower Station. (2) Theoretic analysis of rock mass containing intermittent joints The shear strength mechanisms of joint and rock bridge are analyzed respectively. And the multiple modes of failure on different stress condition are summarized and supplied. Then, through introducing deformation compatibility equation in normal direction, the direct shear strength formulation and compression shear strength formulation for coplanar intermittent joints, as well as compression shear strength formulation for ladderlike intermittent joints are deducted respectively. In order to apply the deducted formulation conveniently in the real projects, a relationship between these formulations and Mohr-Coulomb hypothesis is built up. (3) Model test of rock mass containing intermittent joints Model tests are adopted to study the mechanical mechanism of joints to rock masses. The failure modes of rock mass containing intermittent joints are summarized from the model test. Six typical failure modes are found in the test, and brittle failures are the main failure mode. The evolvement processes of shear stress, shear displacement, normal stress and normal displacement are monitored by using rigid servo test machine. And the deformation and failure character during the loading process is analyzed. According to the model test, the failure modes quite depend on the joint distribution, connectivity and stress states. According to the contrastive analysis of complete stress strain curve, different failure developing stages are found in the intact rock, across jointed rock mass and intermittent jointed rock mass. There are four typical stages in the stress strain curve of intact rock, namely shear contraction stage, linear elastic stage, failure stage and residual strength stage. There are three typical stages in the across jointed rock mass, namely linear elastic stage, transition zone and sliding failure stage. Correspondingly, five typical stages are found in the intermittent jointed rock mass, namely linear elastic stage, sliding of joint, steady growth of post-crack, joint coalescence failure, and residual strength. According to strength analysis, the failure envelopes of intact rock and across jointed rock mass are the upper bound and lower bound separately. The strength of intermittent jointed rock mass can be evaluated by reducing the bandwidth of the failure envelope with geo-mechanics analysis. (4) Numerical test of rock mass Two sets of methods, i.e. the distinct element method (DEC) based on in-situ geology mapping and the realistic failure process analysis (RFPA) based on high-definition digital imaging, are developed and introduced. The operation process and analysis results are demonstrated detailedly from the research on parameters of rock mass based on numerical test in the Jinping First Stage Hydropower Station and Baihetan Hydropower Station. By comparison，the advantages and disadvantages are discussed. Then the applicable fields are figured out respectively. (5) Intelligent evaluation based on artificial neural network (ANN) The characters of both ANN and parameter evaluation of rock mass are discussed and summarized. According to the investigations, ANN has a bright application future in the field of parameter evaluation of rock mass. Intelligent evaluation of mechanical parameters in the Jinping First Stage Hydropower Station is taken as an example to demonstrate the analysis process. The problems in five aspects, i. e. sample selection, network design, initial value selection, learning rate and expected error, are discussed detailedly.

Permutation Tests for Classification

We introduce and explore an approach to estimating statistical significance of classification accuracy, which is particularly useful in scientific applications of machine learning where high dimensionality of the data and the small number of training examples render most standard convergence bounds too loose to yield a meaningful guarantee of the generalization ability of the classifier. Instead, we estimate statistical significance of the observed classification accuracy, or the likelihood of observing such accuracy by chance due to spurious correlations of the high-dimensional data patterns with the class labels in the given training set. We adopt permutation testing, a non-parametric technique previously developed in classical statistics for hypothesis testing in the generative setting (i.e., comparing two probability distributions). We demonstrate the method on real examples from neuroimaging studies and DNA microarray analysis and suggest a theoretical analysis of the procedure that relates the asymptotic behavior of the test to the existing convergence bounds.

Comparative evaluation of serologic tests for celiac disease: a European initiative toward standardization.

BACKGROUND: Serologic methods have been used widely to test for celiac disease and have gained importance in diagnostic definition and in new epidemiologic findings. However, there is no standardization, and there are no reference protocols and materials. METHODS: The European working group on Serological Screening for Celiac Disease has defined robust noncommercial test protocols for immunoglobulin (Ig)G and IgA gliadin antibodies and for IgA autoantibodies against endomysium and tissue transglutaminase. Standard curves were linear in the decisive range, and intra-assay variation coefficients were less than 5% to 10%. Calibration was performed with a group reference serum. Joint cutoff limits were used. Seven laboratories took part in the final collaborative study on 252 randomized sera classified by histology (103 pediatric and adult patients with active celiac disease, 89 disease control subjects, and 60 blood donors). RESULTS: IgA autoantibodies against endomysium and tissue transglutaminase rendered superior sensitivity (90% and 93%, respectively) and specificity (99% and 95%, respectively) over IgA and IgG gliadin antibodies. Tissue transglutaminase antibody testing showed superior receiver operating characteristic performance compared with gliadin antibodies. The K values for interlaboratory reproducibility showed superiority for IgA endomysium (0.93) in comparison with tissue transglutaminase antibodies (0.83) and gliadin antibodies (0.82 for IgG, 0.62 for IgA). CONCLUSIONS: Basic criteria of standardization and quality assessment must be fulfilled by any given test protocol proposed for serologic investigation of celiac disease. The working group has produced robust test protocols and reference materials available for standardization to further improve reliability of serologic testing for celiac disease.