Comparison of measles IgG enzyme immunoassays (EIA) versus plaque reduction neutralization test (PRNT) for measuring measles serostatus: a systematic review of head-to-head analyses of measles IgG EIA and PRNT

Lutz, Chelsea S.; Hasan, Alvira Z.; Bolotin, Shelly; Crowcroft, Natasha S.; Cutts, Felicity T.; Joh, Eugene; Loisate, Stacie; Moss, William J.; Osman, Selma; Hayford, Kyla

doi:10.1186/s12879-023-08199-8

Table 3 High quality studies diagnostic accuracy measures (Siemens Enzygnost/Dade Behring only)

From: Comparison of measles IgG enzyme immunoassays (EIA) versus plaque reduction neutralization test (PRNT) for measuring measles serostatus: a systematic review of head-to-head analyses of measles IgG EIA and PRNT

Study	N of samples tested	Age	EIA threshold	PRNT threshold	EIA equivocal grouped as	TP	FP	FN	TN	Sensitivity % (95% CI)	Specificity % (95% CI)	PPV % (95% CI)	NPV % (95% CI)	Kappa statistic	R
Cohen 2006 [25]	100	NR	< 0.1 O.D	Batch specific cut off^a	Positive	69	0	8	23	89.6 (80.6–95.4)	100.0 (85.2–100.0)	100.0(94.8–100.0)^c	74.2 (55.4–88.1)^c	NR	83.0%
Cohen 2008 [21]^e	210	9 m	< 0.1 O.D (Automatic)	≥ 120 mIU/mL	Positive	118	2	60	30	66.3 (58.8–73.2)^d	93.8 (79.2–99.2)^d	98.3 (94.1–99.8)^d	33.3 (23.7–44.1)^d	NR	0.67^e
			< 0.1 O.D (Automatic)	≥ 120 mIU/mL	Negative	57	0	121	32	32.0 (25.0–39.0)^d	100.0 (89.0–100.0)^d	100.0 (93.7–100.0)^d	20.9 (14.8–28.2)^d	NR	0.67^e
			< 0.1 O.D (Manual)	≥ 120 mIU/mL	Positive	156	10	22	22	87.6 (81.9–92.1)^d	68.8(50.0–83.9)^d	94.0 (89.2–97.1)^d	50.0 (34.6–65.4)^d	NR	NR
			< 0.1 O.D (Manual)	≥ 120 mIU/mL	Negative	110	1	68	31	62.0 (54.0–69.0)^d	97.0 (84.0–100.0)^d	99.1 (95.1–100.0)^d	31.3 (22.4–41.4)^d	NR	NR
Dorigo-Zetsma 2015 [45]	154	≥ 18yrs	< 0.1 O.D	≥ 120 mIU/mL	Positive	139	0	14	1	90.8 (85.1–94.9)	100.0 (2.5–100.0)^c	100.0 (97.4–100.0)^c	6.7 (0.2–31.9)^c	NR	NR
Ratnam 1995 [63]	1287	12-15 m	< 0.1 O.D	≥ 120 mIU/mL	Excluded	160	4	0	39	100.0 (97.7–100.0)	90.7 (77.9–97.4)	97.6 (93.9–99.3)	100.0 (91.0–100.0)	NR	NR
				≥ 8 mIU/mL	Excluded	623	6	100	538	86.2 (83.4–88.6)	98.9 (97.6–99.6)	99.0 (97.9–99.6)	84.3 (81.3–87.1)	NR	NR
Ratnam 1995 [63]	229	1-16yrs	< 0.1 O.D	≥ 120 mIU/mL	Excluded	588	41	7	631	98.8 (97.6–99.5)	93.9 (91.8–95.6)	93.5 (91.3–95.3)	98.9 (97.8–99.6)	NR	NR
				≥ 8 mIU/mL	Excluded	164	0	22	17	88.2 (82.6–92.4)	100.0 (80.5–100.0)	100.0 (97.8–100.0)	43.6 (27.8–60.4)	NR	NR
Tischer 2007 [27]	151	NR	< 0.1 O.D	≥ 40 ± 20 mIU/mL^b	Positive	122	0	6	23	95.3 (90.1–98.3)	100.0 (85.2–100.0)	100.0 (97.0–100.0)^c	79.3 (60.3–92.0)^c	NR	NR
Warrener 2018 [67]	316	4-15 m & 12-75 m	NR	≥ 120 mIU/mL	Positive	183	4	13	116	93.4 (88.9–96.4)	96.7 (91.7–99.1)	97.9 (94.6–99.4)	89.9(83.4–94.5)	NR	0.83
	113	4-15 m	NR	≥ 120 mIU/mL	Positive	122	1	5	95	96.1 (91.1–98.7)	99.0 (94.3–100.0)	99 .2 (95.6–100.0)^c	95.0 (88.7–98.4)^c	NR	NR
	203	12-75 m	NR	≥ 120 mIU/mL	Positive	171	3	8	21	95.5 (91.4–98.1)	87.5 (67.6–97.3)	98.3 (95.0–99.6)^c	72.4 (52.8–87.3)^c	NR	NR

CI Confidence interval, EIA Enzyme immunoassay, FN False negatives, FP False positives, TN True negatives, m Months, NPV Negative predictive value, NE Not estimable, NR Not reported, O.D Optical density, PRNT Plaque reduction neutralization test, PPV Positive predictive value, R Correlation coefficient, TP True positives, yrs Years
^aEIA thresholds reported did not use or did not explicitly report to use manufacturers recommendation
^bReported to use methods other than those described in Albrecht et. al. 1981 or did not describe methodology
^cEstimates presented were not reported by authors but calculated using data reported
^dCohen 2008 authors reported weighted estimates, unweighted estimates displayed
^eThe authors reported overall correlation for the automated ELISA (0.67) and manual ELISAs (0.59)
^eAll negative, low positive, unusual PRN profiles, and random subset of high PRN positives selected for EIA testing

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ISSN: 1471-2334

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