Effective screening strategies for safe opening of universities under Omicron and Delta variants of COVID-19.

As new COVID-19 variants emerge, and disease and population characteristics change, screening strategies may also need to change. We develop a decision-making model that can assist a college to determine an optimal screening strategy based on their characteristics and resources, considering COVID-19 infections/hospitalizations/deaths; peak daily hospitalizations; and the tests required. We also use this tool to generate screening guidelines for the safe opening of college campuses.

Benefits of integrated screening and vaccination for infection control.

Importance: Screening and vaccination are essential in the fight against infectious diseases, but need to be integrated and customized based on community and disease characteristics.

Objective: To develop effective screening and vaccination strategies, customized for a college campus, to reduce COVID-19 infections, hospitalizations, deaths, and peak hospitalizations.

Design, Setting, And Participants: We construct a compartmental model of disease spread under vaccination and routine screening, and study the efficacy of four mitigation strategies (routine screening only, vaccination only, vaccination with partial or full routine screening), and a no-intervention strategy.

Screening multi-dimensional heterogeneous populations for infectious diseases under scarce testing resources, with application to COVID-19.

Testing provides essential information for managing infectious disease outbreaks, such as the COVID-19 pandemic. When testing resources are scarce, an important managerial decision is who to test. This decision is compounded by the fact that potential testing subjects are heterogeneous in multiple dimensions that are important to consider, including their likelihood of being disease-positive, and how much potential harm would be averted through testing and the subsequent interventions.

A robust pooled testing approach to expand COVID-19 screening capacity.

Limited testing capacity for COVID-19 has hampered the pandemic response. Pooling is a testing method wherein samples from specimens (e.g.

A methodology for deriving the sensitivity of pooled testing, based on viral load progression and pooling dilution.

Background: Pooled testing, in which biological specimens from multiple subjects are combined into a testing pool and tested via a single test, is a common testing method for both surveillance and screening activities. The sensitivity of pooled testing for various pool sizes is an essential input for surveillance and screening optimization, including testing pool design. However, clinical data on test sensitivity values for different pool sizes are limited, and do not provide a functional relationship between test sensitivity and pool size.

Sequential prevalence estimation with pooling and continuous test outcomes.

Prevalence estimation is crucial for controlling the spread of infections and diseases and for planning of health care services. Prevalence estimation is typically conducted via pooled, or group, testing due to limited testing budgets. We study a sequential estimation procedure that uses continuous pool readings and considers the dilution effect of pooling so as to efficiently estimate an unknown prevalence rate.

Residual risk and waste in donated blood with pooled nucleic acid testing.

An accurate estimation of the residual risk of transfusion-transmittable infections (TTIs), which includes the human immunodeficiency virus (HIV), hepatitis B and C viruses (HBV, HCV), among others, is essential, as it provides the basis for blood screening assay selection. While the highly sensitive nucleic acid testing (NAT) technology has recently become available, it is highly costly. As a result, in most countries, including the United States, the current practice for human immunodeficiency virus, hepatitis B virus, hepatitis C virus screening in donated blood is to use pooled NAT.

Cost-effectiveness of Babesia microti antibody and nucleic acid blood donation screening using results from prospective investigational studies.

Background: Babesia microti causes transfusion-transmitted babesiosis (TTB); currently, blood donor screening assays are unlicensed but used investigationally.

Study Design And Methods: We developed a decision tree model assessing the comparative- and cost-effectiveness of B. microti blood donation screening strategies in endemic areas compared to the status quo (question regarding a history of babesiosis), including testing by: (1) universal antibody (Ab), (2) universal polymerase chain reaction (PCR), (3) universal Ab/PCR, and (4) recipient risk-targeted Ab/PCR.

A socio-technical, probabilistic risk assessment model for surgical site infections in ambulatory surgery centers.

Background: To understand how structural and process elements may affect the risk for surgical site infections (SSIs) in the ambulatory surgery center (ASC) environment, the researchers employed a tool known as socio-technical probabilistic risk assessment (ST-PRA). ST-PRA is particularly helpful for estimating risks in outcomes that are very rare, such as the risk of SSI in ASCs.

Objective: Study objectives were to (1) identify the risk factors associated with SSIs resulting from procedures performed at ASCs and (2) design an intervention to mitigate the likelihood of SSIs for the most common risk factors that were identified by the ST-PRA for a particular surgical procedure.

Proactive Risk Assessment of Surgical Site Infections in Ambulatory Surgery Centers.

Background: The Socio-Technical Probabilistic Risk Assessment, a proactive risk assessment tool imported from high-risk industries, was used to identify risks for surgical site infections (SSIs) associated with the ambulatory surgery center setting and to guide improvement efforts.

Objectives: This study had 2 primary objectives: (1) to identify the critical risk factors associated with SSIs resulting from procedures performed at ambulatory surgery centers and (2) to design an intervention to mitigate the probability of SSI for the highest risk factors identified.

Methods: Inputs included quantitative and qualitative data sources from the evidence-based literature and from health care providers.

A probabilistic method for the estimation of residual risk in donated blood.

The residual risk (RR) of transfusion-transmitted infections, including the human immunodeficiency virus and hepatitis B and C viruses, is typically estimated by the incidence[Formula: see text]window period model, which relies on the following restrictive assumptions: Each screening test, with probability 1, (1) detects an infected unit outside of the test's window period; (2) fails to detect an infected unit within the window period; and (3) correctly identifies an infection-free unit. These assumptions need not hold in practice due to random or systemic errors and individual variations in the window period. We develop a probability model that accurately estimates the RR by relaxing these assumptions, and quantify their impact using a published cost-effectiveness study and also within an optimization model.