Robust combination testing: methods and application to COVID-19 detection

Sanjay Jain, Jónas Oddur Jónasson, Jean Pauphilet and Kamalini Ramdas

No 1009, Economics Series Working Papers from University of Oxford, Department of Economics

Abstract: Simple and affordable testing tools are often not accurate enough to be operationally relevant. For COVID-19 detection, rapid point-of-care tests are cheap and provide results in minutes, but largely fail policymakers’ accuracy requirements. We propose an analytical methodology, based on robust optimization, that identifies optimal combinations of results from cheap tests for increased predictive accuracy. This methodological tool allows policymakers to credibly quantify the benefits from combination testing and thus break the trade-off between cost and accuracy. Our methodology is robust to noisy and partially missing input data and incorporates operational constraints—relevant considerations in practice. We apply our methodology to two datasets containing individual-level results of multiple COVID-19 rapid antibody and antigen tests, respectively, to generate Pareto-dominating receiver operating characteristic (ROC) curves. We find that combining only three rapid tests increases out-of-sample area under the curve (AUC) by 4% (6%) compared with the best performing individual test for antibody (antigen) detection. We also find that a policymaker who requires a specificity of at least 0.95 can improve sensitivity by 8% and 2% for antibody and antigen testing, respectively, relative to available combination testing heuristics. Our numerical analysis demonstrates that robust optimization is a powerful tool to avoid overfitting, accommodate missing data, and improve out-of-sample performance. Based on our analytical and empirical results, policymakers should consider approving and deploying a curated combination of cheap point-of-care tests in settings where ‘gold standard’ tests are too expensive or too slow.

Date: 2023-04-11
References: View references in EconPapers View complete reference list from CitEc
Citations:

Downloads: (external link)
https://ora.ox.ac.uk/objects/uuid:49e5c5fe-93b5-4480-ba03-31247605a9f1 (application/pdf)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:oxf:wpaper:1009

Access Statistics for this paper

More papers in Economics Series Working Papers from University of Oxford, Department of Economics Contact information at EDIRC.
Bibliographic data for series maintained by Anne Pouliquen (facultyadmin@economics.ox.ac.uk this e-mail address is bad, please contact repec@repec.org).