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Evaluation of the Performance of the IDvet IFN-Gamma Test for Diagnosis of Bovine Tuberculosis in Spain

机译:IDvetIFN-γ测试在西班牙牛结核病诊断中的性能评估

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In Spain, the national bovine tuberculosis (bTB) eradication program is based on yearly skin testing of every ≥6 weeks old animal using the single or comparative tuberculin test and parallel use of the interferon-gamma (IFN-γ) assay as an ancillary diagnostic test in infected herds. There are several versions of the latter. Recently, a new commercial IDvet IFN-γ assay has been authorized for use in the program, but there is limited scientific evidence about its performance in different epidemiological settings. Therefore, two studies to evaluate the performance of the IDvet assay were conducted. In study 1, a concordance analysis between the new IDvet and the Bovigam IFN-γ assay in use in Spain for over 10 years was conducted. In study 2, results from the IDvet assay when applied in tandem with a single intradermal tuberculin (SIT) test were used to evaluate the concordance between both tests and to estimate their sensitivity (Se) and specificity (Sp) using a Bayesian latent-class model. Field data from cattle herds located in Madrid and Castilla y Leon (Spain) were collected. For study 1, herd selection was based on a high expected prevalence of reactors to the IFN-γ assay, while herds were selected at random to estimate Se and Sp of the new IDvet assay in study 2. Agreement between the results obtained with both kits for IFN-γ assay was poor (Kappa= 0.20), and a receiver operating characteristic (ROC) analysis indicated a low Se of the new IDvet relative to the Bovigam in a heavily bTB infected population. The Bayesian latent-class analysis estimated the Se of the IDvet assay to be 36.7% [95% probability posterior interval (PPI) 14.7%-78.8%] with estimated Sp close to 100% when the cut-off recommended by the manufacturer (35) was applied. At the alternative cut-off values of 16 and 4, the estimated Se of the IDvet assay increased to 49.0% (PPI: 24.8-94.1%) and 56.0% (PPI: 30.8-96.3%), respectively, while maintaining a high specificity. The results suggest that the new IDvet assay may have lower sensitivity than the Bovigam for diagnosis of bTB in cattle herds in Spain, and that adjusting its cut-off might be considered.
机译:在西班牙,国家牛结核病(bTB)根除计划基于每6周龄以上动物的年度皮肤测试,使用单次或比较结核菌素测试,以及并行使用干扰素-γ(IFN-γ)检测作为辅助诊断在受感染的牛群中进行测试。后者有多个版本。最近,一种新的商业IDvetIFN-γ检测方法已被授权用于该程序,但关于其在不同流行病学背景下的性能的科学证据有限。因此,进行了两项评估IDvet分析性能的研究。在研究1中,对新IDvet和在西班牙使用了10多年的BovigamIFN-γ测定方法进行了一致性分析。在研究2中,将IDvet分析的结果与单个皮内结核菌素(SIT)测试串联使用时,用于评估这两个测试之间的一致性,并使用贝叶斯潜伏类来评估其敏感性(Se)和特异性(Sp)模型。收集了来自马德里和西班牙卡斯蒂利亚-莱昂的牛群的现场数据。对于研究1,选择猪群是基于对IFN-γ测定法反应器的较高预期患病率,而随机选择牛群是为了估计研究2中新IDvet测定法的Se和Sp。 IFN-γ测定的结果较差(Kappa = 0.20),并且接受者的工作特征(ROC)分析表明,在感染了大量bTB的人群中,新IDvet相对于Bovigam的Se低。贝叶斯潜在类别分析估计IDvet分析的Se为36.7%[95%概率后验间隔(PPI)14.7%-78.8%],当制造商建议的临界值时,估计Sp接近100%(35 )已应用。在16和4的替代临界值下,IDvet分析的估计硒分别增加到49.0%(PPI:24.8-94.1%)和56.0%(PPI:30.8-96.3%),同时保持高特异性。结果表明,对于西班牙牛群中bTB的诊断,新的IDvet测定法的灵敏度可能低于Bovigam,因此可以考虑调整其临界值。

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