Two-stage hierarchical group testing for multiple infections with application to the infertility prevention project

Joshua M. Tebbs, Christopher S. Mcmahan, Christopher R. Bilder

Research output: Contribution to journalArticlepeer-review

39 Scopus citations


Summary: Screening for sexually transmitted diseases (STDs) has benefited greatly from the use of group testing (pooled testing) to lower costs. With the development of assays that detect multiple infections, screening practices now involve testing pools of individuals for multiple infections simultaneously. Building on the research for single infection group testing procedures, we examine the performance of group testing for multiple infections. Our work is motivated by chlamydia and gonorrhea testing for the infertility prevention project (IPP), a national program in the United States. We consider a two-stage pooling algorithm currently used to perform testing for the IPP. We first derive the operating characteristics of this algorithm for classification purposes (e.g., expected number of tests, misclassification probabilities, etc.) and identify pool sizes that minimize the expected number of tests. We then develop an expectation-maximization (EM) algorithm to estimate probabilities of infection using both group and individual retest responses. Our research shows that group testing can offer large cost savings when classifying individuals for multiple infections and can provide prevalence estimates that are actually more efficient than those from individual testing.

Original languageEnglish (US)
Pages (from-to)1064-1073
Number of pages10
Issue number4
StatePublished - Dec 2013


  • Correlated binary response
  • EM algorithm
  • Efficiency
  • Pooled testing
  • Screening
  • Specimen pooling

ASJC Scopus subject areas

  • Statistics and Probability
  • General Biochemistry, Genetics and Molecular Biology
  • General Immunology and Microbiology
  • General Agricultural and Biological Sciences
  • Applied Mathematics


Dive into the research topics of 'Two-stage hierarchical group testing for multiple infections with application to the infertility prevention project'. Together they form a unique fingerprint.

Cite this