{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T10:33:30Z","timestamp":1780914810392,"version":"3.54.1"},"reference-count":7,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2024,9,3]],"date-time":"2024-09-03T00:00:00Z","timestamp":1725321600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>In this study, we evaluated the potential utility of reporting a quantitative Lyme serologic test index to improve the utility of results from first-tier Lyme assays.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Serum from consecutive samples sent to our laboratory for Lyme testing were tested on 2 commercial first-tier Lyme assays and evaluated to determine the probability of second-tier confirmation based on the serologic index value.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>For both assays, we identified an index value above which 100% of samples confirmed on second-tier testing using both standard and modified 2-tier testing algorithms. Lower rates of confirmation were observed for positive or equivocal samples with lower index values.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The use of a Lyme test index value may eliminate the need for confirmatory testing on many positive first-tier samples, providing more rapid turnaround time to a definitive result. This practice would also increase efficiency in the clinical laboratory.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ajcp\/aqae112","type":"journal-article","created":{"date-parts":[[2024,9,4]],"date-time":"2024-09-04T01:41:21Z","timestamp":1725414081000},"page":"327-331","source":"Crossref","is-referenced-by-count":1,"title":["Evaluation of Lyme serologic quantitative test indexes: High first-tier test index values predict positive second-tier result in standard and modified 2-tier Lyme testing algorithms"],"prefix":"10.1093","volume":"163","author":[{"given":"Elizabeth Lee","family":"Lewandrowski","sequence":"first","affiliation":[{"name":"Department of Pathology, Division of Clinical Laboratories and Molecular Medicine, Massachusetts General Hospital , Boston, MA ,","place":["US"]},{"name":"Harvard Medical School , Boston, MA ,","place":["US"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John A","family":"Branda","sequence":"additional","affiliation":[{"name":"Department of Pathology, Division of Clinical Laboratories and Molecular Medicine, Massachusetts General Hospital , Boston, MA ,","place":["US"]},{"name":"Harvard Medical School , Boston, MA ,","place":["US"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Klontz","sequence":"additional","affiliation":[{"name":"Department of Pathology, Division of Clinical Laboratories and Molecular Medicine, Massachusetts General Hospital , Boston, MA ,","place":["US"]},{"name":"Harvard Medical School , Boston, MA ,","place":["US"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lise E","family":"Nigrovic","sequence":"additional","affiliation":[{"name":"Harvard Medical School , Boston, MA ,","place":["US"]},{"name":"Division of Emergency Medicine, Boston Children\u2019s Hospital , Boston, MA ,","place":["US"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kent","family":"Lewandrowski","sequence":"additional","affiliation":[{"name":"Department of Pathology, Division of Clinical Laboratories and Molecular Medicine, Massachusetts General Hospital , Boston, MA ,","place":["US"]},{"name":"Harvard Medical School , Boston, MA ,","place":["US"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,9,3]]},"reference":[{"key":"2025031001313584600_CIT0001","doi-asserted-by":"crossref","first-page":"1260","DOI":"10.1097\/INF.0000000000000858","article-title":"The positive predictive value of Lyme ELISA for the diagnosis of Lyme disease in children","volume":"34","author":"Lipsett","year":"2015","journal-title":"The Ped Infec Dis Journal."},{"issue":"11","key":"2025031001313584600_CIT0002","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/j.diagmicrobio.2018.12.001","article-title":"Higher C6 immunoassay index values correlate with a diagnosis on noncutaneous Lyme disease","volume":"94","author":"Nigrovic","year":"2019","journal-title":"Diag Micro Infec Dis."},{"issue":"8","key":"2025031001313584600_CIT0003","doi-asserted-by":"crossref","first-page":"1074","DOI":"10.1093\/cid\/cix043","article-title":"Evaluation of modified 2-tiered serodiagnostic testing algorithms for early Lyme disease","volume":"64","author":"Branda","year":"2017","journal-title":"Clin Infec Dis."},{"issue":"1","key":"2025031001313584600_CIT0004","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1093\/cid\/ciaa1215","article-title":"Clinical Practice Guidelines by the Infectious Diseases Society of America (IDSA), American Academy of Neurology (AAN), and American College of Rheumatology (ACR): 2020 Guidelines for the Prevention, Diagnosis and Treatment of Lyme Disease","volume":"72","author":"Lantos","year":"2021","journal-title":"Clin Infect Dis."},{"issue":"10","key":"2025031001313584600_CIT0005","doi-asserted-by":"crossref","first-page":"e00547","DOI":"10.1128\/JCM.00547-19","article-title":"Evaluation of the modified two-tiered testing strategy for the diagnosis of Lyme disease in children","volume":"57","author":"Lipsett","year":"2019","journal-title":"J Clin Microbiol."},{"issue":"5","key":"2025031001313584600_CIT0006","doi-asserted-by":"crossref","first-page":"e0252821","DOI":"10.1128\/jcm.02528-21","article-title":"Multicenter clinical evaluation of modified two-tiered testing algorithms for Lyme disease using Zeus Scientific Commercial Assays","volume":"60","author":"Sfeir","year":"2022","journal-title":"J Clin Microbiol."},{"issue":"Supplement_1","key":"2025031001313584600_CIT0007","doi-asserted-by":"publisher","first-page":"S76","DOI":"10.1093\/infdis\/jiae229","article-title":"Comparative evaluation of commercial test kits cleared for use in modified two-tiered testing algorithms for serodiagnosis of Lyme disease","volume":"230","author":"Lewandrowski","year":"2024","journal-title":"J Infect Dis."}],"container-title":["American Journal of Clinical Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ajcp\/article-pdf\/163\/3\/327\/59004948\/aqae112.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajcp\/article-pdf\/163\/3\/327\/59004948\/aqae112.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T01:31:45Z","timestamp":1741570305000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajcp\/article\/163\/3\/327\/7748431"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,3]]},"references-count":7,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2024,9,3]]},"published-print":{"date-parts":[[2025,3,8]]}},"URL":"https:\/\/doi.org\/10.1093\/ajcp\/aqae112","relation":{},"ISSN":["0002-9173","1943-7722"],"issn-type":[{"value":"0002-9173","type":"print"},{"value":"1943-7722","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,3]]},"published":{"date-parts":[[2024,9,3]]}}}