Piras, Maria Adriana and Aceti, Antonio (2000) Preliminary falsification of EIA screening is cost‐effective in the two‐step serodiagnosis of lyme disease. The Journal of Infectious Diseases, Vol. 181 (2), p. 802. ISSN 0022-1899. Article.
We read with great interest the article by Trevejo et al. that described a simplified procedure for the laboratory diagnosis of Lyme disease (LD). The authors assumed as “certain” the clinical diagnosis of LD and on this basis calculated the sensitivity of 3 different diagnostic approaches. We suggest that there is some bias in the assumption that 25 EIA-positive serum samples plus 2 more Western immunoblot (WB)–confirmed samples, among equivocal results, sum up to a sensitivity of 41%, by the authors’ simplified method, in the early phase of LD. Similarly, the assumption was made that 39 EIA-positive sera, with no WB confirmation of equivocal results, give a sensitivity of 71% in the convalescent phase. The authors ignore that 6 (22%) of 27 and 23 (59%) of 39 EIA-positive results were disproved by WB. We cannot understand what scientific reasoning allows the omission of the WB-unconfirmed, EIA-equivocal results and the inclusion of WB-unconfirmed but EIApositive cases.
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