Group Testing Considerations: A Useful Method For The Clinical Laboratory

Abstract

Robert Dorfman first suggested group testing, commonly referred to as pooled sample testing, in 1943. Although sample pooling has been used extensively in blood banks, clinical laboratories have historically frowned upon it. To counteract supply shortages, clinical laboratories are becoming more interested in group testing as a result of the ongoing COVID-19 pandemic. We provide a practical method that a clinical laboratory may use to implement pooled testing for SARS-CoV-2 PCR testing, as well as five criteria to evaluate an analyte's suitability for pooled sample testing generally. The five standards that we suggest are: In order to maximize public health outcomes, it is imperative that (1) the analyte concentrations in diseased individuals be at least one order of magnitude (10 times) higher than in healthy individuals, (2) sample dilution not unduly reduce clinical sensitivity, (3) the current prevalence be low enough for the number of samples pooled for the particular protocol, (4) there is no need for a quick turnaround time, and (5) resource rationing be implemented. We recommend the following five essential steps for a successful implementation: (1) identifying the pooling window (pre-pre analytical, pre-analytical, and analytical); (2) verifying the pooling protocol; (3) making sure the archival system and infrastructure are sufficient; (4) setting up the laboratory information system; and (5) staff training During pool testing.