{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T12:22:10Z","timestamp":1788265330410,"version":"build-2803163510"},"reference-count":22,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,5,27]],"date-time":"2021-05-27T00:00:00Z","timestamp":1622073600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Pooled testing is a potentially efficient alternative strategy for COVID\u201019 testing in congregate settings. We evaluated the utility and cost\u2010savings of pooled testing based on imperfect test performance and potential dilution effect due to pooling and created a practical calculator for online use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We developed a 2\u2010stage pooled testing model accounting for dilution. The model was applied to hypothetical scenarios of 100 specimens collected during a one\u2010week time\u2010horizon cycle for varying levels of COVID\u201019 prevalence and test sensitivity and specificity, and to 338 skilled nursing facilities (SNFs) in Los Angeles County (Los Angeles) (data collected and analyzed in 2020).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Optimal pool sizes ranged from 1 to 12 in instances where there is a least one case in the batch of specimens. 40% of Los Angeles SNFs had more than one case triggering a response\u2010testing strategy. The median number (minimum; maximum) of tests performed per facility were 56 (14; 356) for a pool size of 4, 64 (13; 429) for a pool size of 10, and 52 (11; 352) for an optimal pool size strategy among response\u2010testing facilities. The median costs of tests in response\u2010testing facilities were $8250 ($1100; $46,100), $6000 ($1340; $37,700), $6820 ($1260; $43,540), and $5960 ($1100; $37,380) when adopting individual testing, a pooled testing strategy using pool sizes of 4, 10, and optimal pool size, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Pooled testing is an efficient strategy for congregate settings with a low prevalence of COVID\u201019. Dilution as a result of pooling can lead to erroneous false\u2010negative results.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmv.27054","type":"journal-article","created":{"date-parts":[[2021,4,30]],"date-time":"2021-04-30T17:25:10Z","timestamp":1619803510000},"page":"5396-5404","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Optimal uses of pooled testing for COVID\u201019 incorporating imperfect test performance and pool dilution effect: An application to congregate settings in Los Angeles County"],"prefix":"10.1002","volume":"93","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5932-6169","authenticated-orcid":false,"given":"Roch A.","family":"Nianogo","sequence":"first","affiliation":[{"name":"Department of Epidemiology, Fielding School of Public Health University of California, Los Angeles (UCLA)  Los Angeles California USA"},{"name":"California Center for Population Research  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I. Obi","family":"Emeruwa","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management UCLA Fielding School of Public Health  Los Angeles California USA"},{"name":"UCLA Clinical and Translational Science Institute  Los Angeles California USA"},{"name":"Division of Pulmonary and Critical Care Medicine UCLA David Geffen School of Medicine  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8600-0348","authenticated-orcid":false,"given":"Prabhu","family":"Gounder","sequence":"additional","affiliation":[{"name":"Los Angeles County Department of Public Health (LACDPH)  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8101-5885","authenticated-orcid":false,"given":"Vladimir","family":"Manuel","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine UCLA David Geffen School of Medicine  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4305-2447","authenticated-orcid":false,"given":"Nathaniel W.","family":"Anderson","sequence":"additional","affiliation":[{"name":"California Center for Population Research  Los Angeles California USA"},{"name":"Department of Health Policy and Management UCLA Fielding School of Public Health  Los Angeles California USA"},{"name":"UCLA Clinical and Translational Science Institute  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4120-8559","authenticated-orcid":false,"given":"Tony","family":"Kuo","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Fielding School of Public Health University of California, Los Angeles (UCLA)  Los Angeles California USA"},{"name":"UCLA Clinical and Translational Science Institute  Los Angeles California USA"},{"name":"Department of Family Medicine David Geffen School of Medicine  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1963-2430","authenticated-orcid":false,"given":"Moira","family":"Inkelas","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management UCLA Fielding School of Public Health  Los Angeles California USA"},{"name":"UCLA Clinical and Translational Science Institute  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9067-1697","authenticated-orcid":false,"given":"Onyebuchi A.","family":"Arah","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Fielding School of Public Health University of California, Los Angeles (UCLA)  Los Angeles California USA"},{"name":"California Center for Population Research  Los Angeles California USA"},{"name":"Department of Statistics College of Letters and Science, UCLA  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,5,27]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"White House. 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