Application of diagnostic tests in veterinary epidemiologic studies

Important applications of diagnostic tests in non-clinical areas of veterinary medicine include surveillance, monitoring or screening for disease, prevalence estimation, and risk-factor studies. In this review, we address the processing and analysis of diagnostic data with special emphasis on serological data from enzyme-linked immunosorbent assays (ELISAs). We describe methods that are used to adjust for misclassification (imperfect sensitivity and specificity) in the different applications of diagnostic tests. These methods often have limitations attributable to the uncertainty of sensitivity and specificity estimates. We review descriptive and analytical statistical methods that allow adequate presentation of non-clinical diagnostic data.