{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T23:29:47Z","timestamp":1790378987889,"version":"4.1.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2024,8,27]],"date-time":"2024-08-27T00:00:00Z","timestamp":1724716800000},"content-version":"vor","delay-in-days":239,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100023395","name":"EPSRC Centre for Doctoral Training in Statistical Applied Mathematics at Bath","doi-asserted-by":"publisher","award":["EP\/L015684\/1"],"award-info":[{"award-number":["EP\/L015684\/1"]}],"id":[{"id":"10.13039\/501100023395","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000270","name":"Natural Environment Research Council","doi-asserted-by":"publisher","award":["NE\/N014979\/1"],"award-info":[{"award-number":["NE\/N014979\/1"]}],"id":[{"id":"10.13039\/501100000270","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000270","name":"Natural Environment Research Council","doi-asserted-by":"publisher","award":["NE\/V003909\/1"],"award-info":[{"award-number":["NE\/V003909\/1"]}],"id":[{"id":"10.13039\/501100000270","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000038","name":"Natural Sciences and Engineering Research Council of Canada","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000038","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Nous remercions le Conseil de recherches en sciences naturelles et en g\u00e9nie du Canada"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Diagnostic testing is a key tool in the fight against many infectious diseases. The emergence of pathogen variants that are able to avoid detection by diagnostic testing therefore represents a key challenge for public health. In recent years, variants for multiple pathogens have emerged which escape diagnostic testing, including mutations in Plasmodium falciparum (malaria), Chlamydia trachomatis (chlamydia) and SARS-Cov-2 (Severe acute respiratory syndrome coronavirus 2) (Coronavirus disease 2019). However, little is currently known about when and the extent to which diagnostic test escape will evolve. Here we use a mathematical model to explore how the frequency of diagnostic testing, combined with variation in compliance and efficacy of isolating, together drive the evolution of detection avoidance. We derive key thresholds under which a testing regime will (i) select for diagnostic test avoidance, or (ii) drive the pathogen extinct. Crucially, we show that imperfect compliance with diagnostic testing regimes can have marked effects on selection for detection avoidance, and consequently, for disease control. Yet somewhat counterintuitively, we find that an intermediate level of testing can select for the highest level of detection avoidance. Our results, combined with evidence from various pathogens, demonstrate that the evolution of diagnostic testing avoidance should be carefully considered when designing diagnostic testing regimes.<\/jats:p>","DOI":"10.1093\/emph\/eoae018","type":"journal-article","created":{"date-parts":[[2024,8,27]],"date-time":"2024-08-27T14:28:38Z","timestamp":1724768918000},"page":"248-259","source":"Crossref","is-referenced-by-count":2,"title":["Diagnostic testing and the evolution of detection avoidance by pathogens"],"prefix":"10.1093","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2171-2624","authenticated-orcid":false,"given":"Jason","family":"Wood","sequence":"first","affiliation":[{"name":"Department of Mathematical Sciences, University of Bath , Bath ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5588-7081","authenticated-orcid":false,"given":"Ben","family":"Ashby","sequence":"additional","affiliation":[{"name":"Department of Mathematical Sciences, University of Bath , Bath ,","place":["UK"]},{"name":"Department of Mathematics, Simon Fraser University , Vancouver ,","place":["Canada"]},{"name":"The Pacific Institute on Pathogens, Pandemics and Society (PIPPS), Simon Fraser University , Burnaby, BC ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,8,27]]},"reference":[{"key":"2025052712023443800_CIT0001","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1128\/MMBR.00016-10","article-title":"Origins and evolution of antibiotic resistance","volume":"74","author":"Davies","year":"2010","journal-title":"Microbiol Mol Biol 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