{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,10]],"date-time":"2026-05-10T08:00:58Z","timestamp":1778400058820,"version":"3.51.4"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2022,6,18]],"date-time":"2022-06-18T00:00:00Z","timestamp":1655510400000},"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":[[2022,10,29]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n In 2019, the CDC updated serology testing guidelines for Lyme disease diagnosis to include alternative modified two-tiered testing that replaces the western blots of standard testing with an additional ELISA. Antibody-capture serological assays have also been used as an aid for Lyme diagnosis. A panel of clinically characterized samples from the CDC was tested to compare modified two-tiered testing to the standard two-tiered algorithm and an antibody capture immunoassay.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A CDC panel of 92 samples comprised a range of samples including early Lyme, Lyme neuroborreliosis, Lyme arthritis, infections by other pathogens, and healthy controls. The panel was tested on a standard two-tiered platform by the CDC, the ZEUS Borrelia Test System for modified two-tiered testing, and a lab-developed antibody-capture serological assay. Sensitivity and specificity results from each assay were compared to determine significance.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The antibody-capture assay demonstrated increased sensitivity but decreased specificity compared to the modified and standard two-tiered platforms. There was no statistical difference found between the modified and standard two-tiered platforms.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Improved sensitivity of antibody-capture when testing early Lyme disease samples is offset by decreased specificity, especially with syphilis-positive samples. Modified two-tiered testing is similar to standard two-tiered methods while also being more scalable and simpler to interpret.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/jalm\/jfac047","type":"journal-article","created":{"date-parts":[[2022,6,18]],"date-time":"2022-06-18T13:51:26Z","timestamp":1655560286000},"page":"1445-1449","source":"Crossref","is-referenced-by-count":2,"title":["A Comparison of Lyme Serological Testing Platforms with a Panel of Clinically Characterized Samples from Various Stages of Lyme Disease"],"prefix":"10.1093","volume":"7","author":[{"given":"George W","family":"Pratt","sequence":"first","affiliation":[{"name":"Quest Diagnostics , North Region, Marlborough, MA , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mihae","family":"Platt","sequence":"additional","affiliation":[{"name":"Quest Diagnostics , North Region, Marlborough, MA , USA"},{"name":"Athena Diagnostics , Marlborough, MA , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Velez","sequence":"additional","affiliation":[{"name":"Quest Diagnostics , North Region, Marlborough, MA , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lokinendi V","family":"Rao","sequence":"additional","affiliation":[{"name":"Quest Diagnostics , North Region, Marlborough, MA , USA"},{"name":"UMass Chan Medical School , Worcester, MA , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,6,18]]},"reference":[{"key":"2022102918175292900_jfac047-B1","first-page":"590","article-title":"Notice to readers recommendations for test performance and interpretation from the second national conference on serologic diagnosis of Lyme disease","volume":"44","author":"Centers for Disease Control and Prevention","year":"1995","journal-title":"MMWR"},{"key":"2022102918175292900_jfac047-B2","author":"Centers for Disease Control and 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enzyme immunoassay","volume":"158","author":"Berardi","year":"1988","journal-title":"J Infect Dis"},{"key":"2022102918175292900_jfac047-B6","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1128\/JCM.02735-14","article-title":"Nonstructural protein 1-specific immunoglobulin M and G antibody capture enzyme-linked immunosorbent assays in diagnosis of flaviviral infections in humans","volume":"53","author":"Chao","year":"2015","journal-title":"J Clin Microbiol"},{"key":"2022102918175292900_jfac047-B7","doi-asserted-by":"crossref","first-page":"3755","DOI":"10.1128\/JCM.01409-14","article-title":"Collection and characterization of samples for establishment of a serum repository for Lyme disease diagnostic test development and evaluation","volume":"52","author":"Molins","year":"2014","journal-title":"J Clin Microbiol"},{"key":"2022102918175292900_jfac047-B8","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1093\/infdis\/156.1.183","article-title":"Cross-reactivity in serological tests for Lyme disease and other spirochetal infections","volume":"156","author":"Magnarelli","year":"1987","journal-title":"J Infect Dis"},{"key":"2022102918175292900_jfac047-B9","doi-asserted-by":"crossref","first-page":"125","DOI":"10.14745\/ccdr.v46i05a05","article-title":"Modified two-tiered testing algorithm for Lyme disease serology: the Canadian context","volume":"46","author":"Hatchette","year":"2020","journal-title":"Can Commun Dis Rep"},{"key":"2022102918175292900_jfac047-B10","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"}],"container-title":["The Journal of Applied Laboratory 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