ArticleJournal of evaluation in clinical practice2026
Sequential Screening as Diagnostic Filtering or Substitution: A Bayesian Cost Model of Screening as a Function of Prevalence.
Article in Journal of evaluation in clinical practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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2 authors.
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Abstract
objectiveIn low-prevalence settings, standard screening cascades may generate many false-positive referrals for confirmatory testing, increasing cost, delay, and patient burden. We develop a Bayesian cost model comparing the standard cascade with two sequential architectures: substitution, in which repeated screening replaces immediate confirmation, and filtering, in which repeated screening narrows the group referred for confirmation.
methodsFor disease prevalence
resultsPersistent positivity compounds evidence by replacing
conclusionsSequential screening is a prevalence-dependent design choice, not a universal substitute for diagnosis. Filtering is more clinically conservative because it preserves confirmation while reducing referrals. Substitution is appropriate only when repeated measurements are already embedded in accepted diagnostic standards.
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