NYMC Faculty Publications
Comparative Cost-Effectiveness of Two-Tiered Testing Strategies for Serodiagnosis of Lyme Disease With Noncutaneous Manifestations
Author Type(s)
Faculty
Journal Title
Journal of Clinical Microbiology
First Page
4045
Last Page
4049
Document Type
Article
Publication Date
12-1-2013
Department
Medicine
Abstract
The mainstay of laboratory diagnosis for Lyme disease is two-tiered serological testing, in which a reactive first-tier enzyme-linked immunosorbent assay (ELISA) or an immunofluorescence assay is supplemented by separate IgM and IgG immunoblots. Recent data suggest that the C6 ELISA can be substituted for immunoblots without a reduction in either sensitivity or specificity. In this study, the costs of 4 different two-tiered testing strategies for Lyme disease were compared using the median charges for these tests at 6 commercial diagnostic laboratories in 2012. The study found that a whole-cell sonicate ELISA followed by the C6 ELISA was the most cost-effective two-tiered testing strategy for Lyme disease with acute-phase serum samples. We conclude that the C6 ELISA can substitute for immunoblots in the two-tiered testing protocol for Lyme disease without a loss of sensitivity or specificity and is less expensive.
Recommended Citation
Wormser, G. P., Levin, A., Soman, S., Adenikinju, O., Longo, M., & Branda, J. (2013). Comparative Cost-Effectiveness of Two-Tiered Testing Strategies for Serodiagnosis of Lyme Disease With Noncutaneous Manifestations. Journal of Clinical Microbiology, 51 (12), 4045-4049. Retrieved from https://touroscholar.touro.edu/nymc_fac_pubs/5617
