On the Statistical Testing Methods for Single Laboratory Validation of Qualitative Microbiological Assays with a Paired Design.

Abstract

There are several statistical methods for detecting a difference of detection rates between alternative and reference qualitative microbiological assays in a single laboratory validation study with a paired design. We compared performance of eight methods including McNemar's test, sign test, Wilcoxon signed-rank test, paired t-test, and the regression methods based on conditional logistic (CLOGIT), mixed effects complementary log-log (MCLOGLOG), mixed effects logistic (MLOGIT) models, and a linear mixed effects model (LMM). We first compared the minimum detectable difference in the proportion of detections between the alternative and reference detection methods among these statistical methods for a varied number of test portions. We then compared power and type 1 error rates of these methods using simulated data. The MCLOGLOG and MLOGIT models had the lowest minimum detectable difference, followed by the LMM and paired t-test. The MCLOGLOG and MLOGIT models had the highest average power but were anticonservative when correlation between the pairs of outcome values of the alternative and reference methods was high. The LMM and paired t-test had mostly the highest average power when the correlation was low and the second highest average power when the correlation was high. Type 1 error rates of these last two methods approached the nominal value of significance level when the number of test portions was moderately large (n > 20). The LMM and paired t-test are better choices than other competing methods, and we provide an example using real data.