Improved confidence intervals of a small probability from pooled testing with misclassification

Front Public Health. 2013 Oct 7:1:39. doi: 10.3389/fpubh.2013.00039. eCollection 2013.

Abstract

This article concerns construction of confidence intervals for the prevalence of a rare disease using Dorfman's pooled testing procedure when the disease status is classified with an imperfect biomarker. Such an interval can be derived by converting a confidence interval for the probability that a group is tested positive. Wald confidence intervals based on a normal approximation are shown to be inefficient in terms of coverage probability, even for relatively large number of pools. A few alternatives are proposed and their performance is investigated in terms of coverage probability and length of intervals.

Keywords: confidence intervals; coverage probability; exact inference; pooling; prevalence; rare event; sensitivity; specificity.