A Novel Adaptive Testing Scheme for Multidisease Testing

Testing Smarter, Not More: An Adaptive Approach In the paper titled “A Novel Adaptive Testing Scheme for Multidisease Testing,” Douglas Bish, Ebru Bish, Merve Bodur, and Berk Görgülü develop an adaptive, cost-efficient testing scheme for lab-based multidisease testing, essential for diagnosis and screening, particularly for disease groups that share symptoms but require disease-specific treatments (e.g., respiratory, gastrointestinal, or sexually transmitted diseases). Their proposed adaptive strategy integrates multiplex assays and pooled testing in a novel way, utilizing modern automated testing technologies to build a customized follow-up test for each person, covering only the diseases flagged in that person’s relevant pooled tests. Optimizing such adaptive designs is mathematically demanding, but in a case study of 18 respiratory diseases, based on data from the Centers for Disease Control and Prevention, their adaptive designs yield substantial cost savings (51%–61%) relative to current practice under forecast error and highly seasonal prevalences. By lowering the cost per subject, adaptive designs can expand testing capacity and support earlier detection under resource constraints.