ArticleJournal of clinical microbiology2016
Lyme Borreliosis Serology: Performance of Several Commonly Used Laboratory Diagnostic Tests and a Large Resource Panel of Well-Characterized Patient Samples.
Article in Journal of clinical microbiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
41 citing papers in PubMed, 62 citations in OpenAlex.
- Update on North American tick-borne diseases and how to diagnose them.Journal of clinical microbiology · 2025Review
- Comparison of the Serodiagnostic Accuracy Tests for Lyme Disease in Adults and Children: A Network Meta-Analysis.Pathogens (Basel, Switzerland) · 2025Review
- New Epitopes for the Serodiagnosis of Human Borreliosis.Microorganisms · 2024Article
- Reply to Shah, J.S.; Ramasamy, R. Target Antigens in Western and Line Immunoblots for Supporting the Diagnosis of Lyme Disease. Comment on "Porwancher et al. Immunoblot Criteria for Diagnosis of Lyme Disease: A Comparison of CDC Criteria to Alternative Interpretive Approaches.Pathogens (Basel, Switzerland) · 2024Article
- Diagnostic Precision in Lyme borreliosis: Assessing VlsE and C6 Antigens in a Pediatric Cohort.Diagnostics (Basel, Switzerland) · 2023Article
- Immunoblot Criteria for Diagnosis of Lyme Disease: A Comparison of CDC Criteria to Alternative Interpretive Approaches.Pathogens (Basel, Switzerland) · 2023Article
- Direct Detection of Lyme Borrelia: Recent Advancement and Use of Aptamer Technology.Biomedicines · 2023Review
- Lyme borreliosis diagnosis: state of the art of improvements and innovations.BMC microbiology · 2023Review
- Profiling disease burden and Borrelia seroprevalence in Canadians with complex and chronic illness.PloS one · 2023Article
- Article
- Multicenter Clinical Evaluation of Modified Two-Tiered Testing Algorithms for Lyme Disease Using Zeus Scientific Commercial Assays.Journal of clinical microbiology · 2022Article
- A 60-Year-Old Swiss Woman Presenting with Migratory Radicular Pain Diagnosed with Lyme Disease by Western Blot.The American journal of case reports · 2022Review
- Cross-Reactive Results in Serological Tests for Borreliosis in Patients with Active Viral Infections.Pathogens (Basel, Switzerland) · 2022Article
- Diagnostic Performance of the Novel BioPlex Lyme Serological Assays in European Patients with Lyme Disease.Journal of clinical microbiology · 2021Article
- Laboratory Diagnosis of Lyme Borreliosis.Clinical microbiology reviews · 2021Review
- Serum Epitope Repertoire Analysis Enables Early Detection of Lyme Disease with Improved Sensitivity in an Expandable Multiplex Format.Journal of clinical microbiology · 2021Article
- Diagnostic parameters of modified two-tier testing in European patients with early Lyme disease.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2020Article
- Performance of a Modified Two-Tiered Testing Enzyme Immunoassay Algorithm for Serologic Diagnosis of Lyme Disease in Nova Scotia.Journal of clinical microbiology · 2020Article
- Modified two-tiered testing algorithm for Lyme disease serology: the Canadian context.Canada communicable disease report = Releve des maladies transmissibles au Canada · 2020Review
- A Fully Automated Multiplex Assay for Diagnosis of Lyme Disease with High Specificity and Improved Early Sensitivity.Journal of clinical microbiology · 2020Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The current recommendation for the laboratory confirmation of Lyme disease is serology-based diagnostics. Specifically, a standardized two-tiered testing (STTT) algorithm is applied that utilizes a first-tier immunofluorescence assay or enzyme immunoassay (EIA) that, if the result is positive or equivocal, is followed by second-tier immunoblotting. Despite the standardization and performance achievements, STTT is considered technically complex and subjective, as well as insensitive for early acute infection. These issues have prompted development of novel algorithms and testing platforms. In this study, we evaluated the performance of several commonly used assays for STTT. Several modified two-tiered testing (MTTT) algorithms, including a 2-EIA algorithm and modified criteria for second-tier IgG immunoblots, were also evaluated. All tests were performed on sera from a recently available, well-defined archive of positive- and negative-control patients. Our study demonstrates differences in the results between individual first- and second-tier tests, although the overall agreement of the different STTT algorithms used was strong. In addition, the MTTT algorithm utilizing 2-EIAs was found to be equivalent to all STTT algorithms tested, with agreement ranging from 94 to 97%. The 2-EIA MTTT algorithm slightly enhanced sensitivity in early disease compared to the STTT algorithms evaluated. Furthermore, these data add to the mounting evidence that a 2-EIA-based MTTT algorithm, where immunoblotting is replaced by the C6 EIA, performs as well or better than STTT.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.