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Informative Use of Cycle-Threshold Values to Account for Sampling Variability in Pathogen Detection

Nikiforuk, A. M.; Jassem, A. N.

2023-03-27 infectious diseases
10.1101/2023.03.21.23287544 medRxiv
Show abstract

Nucleic acid amplification tests, like real-time polymerase chain reaction, are widely used for pathogen detection; however, their interpretation rarely accounts for sampling variability. Instead, cycle threshold values are often categorized reducing precision. We describe how pathogen cycle threshold values can be normalized to endogenous host gene expression to correct for sampling variability and compare the validity of this approach to standardization with a standard curve. Normalization serves as a valid alternative to standardization, does not require making a standard curve, increases precision, accounts for sampling variability, and can be easily applied to large clinical or surveillance datasets for informative interpretation.

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