Optimal targeted mass screening in non‐uniform populations with multiple tests and schemes

Jiayi Lin, Hrayer Aprahamian, G. Golovko
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Abstract

We study the problem of designing optimal targeted mass screening of non‐uniform populations. Mass screening is an essential tool that is widely utilized in a variety of settings, for example, preventing infertility through screening programs for sexually transmitted diseases, ensuring a safe blood supply for transfusion, and mitigating the transmission of infectious diseases. The objective of mass screening is to maximize the overall classification accuracy under limited budget. In this paper, we address this problem by proposing a proactive optimization‐based framework that factors in population heterogeneity, limited budget, different testing schemes, the availability of multiple assays, and imperfect assays. By analyzing the resulting optimization problem, we take advantage of the structure of the problem as a multi‐dimensional fractional knapsack problem and identify an efficient globally convergent threshold‐style solution scheme that fully characterizes an optimal solution across the entire budget spectrum. Using real‐world data, we conduct a geographic‐based nationwide case study on targeted COVID‐19 screening in the United States. Our results reveal that the identified screening strategies substantially outperform conventional practices by significantly lowering misclassifications while utilizing the same amount of budget. Moreover, our results provide valuable managerial insights with regard to the distribution of testing schemes, assays, and budget across different geographic regions.
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通过多种检测和方案在非均匀人群中进行最优靶向大规模筛查
我们研究了在非均匀人群中设计最优的靶向质量筛选问题。大规模筛查是一项重要工具,广泛用于各种情况,例如,通过性传播疾病筛查方案预防不孕症,确保输血的安全血液供应,以及减轻传染病的传播。大规模筛选的目标是在有限的预算下实现整体分类精度的最大化。在本文中,我们通过提出一个基于前瞻性优化的框架来解决这一问题,该框架考虑了人口异质性、有限的预算、不同的测试方案、多种检测方法的可用性和不完善的检测方法。通过分析所得到的优化问题,我们利用问题的结构作为一个多维分数背包问题,并确定了一个有效的全局收敛阈值式解决方案,该方案充分表征了整个预算谱的最优解。利用真实世界的数据,我们在美国开展了一项基于地理的全国性COVID - 19靶向筛查案例研究。我们的研究结果表明,确定的筛选策略大大优于传统做法,显著降低错误分类,同时利用相同的预算数额。此外,我们的结果提供了有价值的管理见解,关于测试方案的分布,分析,以及跨不同地理区域的预算。
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