title: Evaluation of cost-effectiveness of targeted sampling methods for detection of Mycobacterium avium subsp paratuberculosis infection in dairy herds.
abstract: OBJECTIVE
  To investigate the epidemiologic and financial impacts of targeted sampling of subpopulations of cows, compared with random sampling of all cows, for classification of dairy herd infection status for paratuberculosis.
  
  
  METHODS
  All cows from 4 infected herds with a low-to-moderate prevalence of paratuberculosis and from 1 noninfected herd in California.
  
  
  METHODS
  The infection status of each cow was classified on the basis of results of an ELISA or combined ELISA and fecal culture results. Thirteen sampling schemes designed to randomly sample cows on the basis of lactation number, stage of lactation, and milk production were evaluated. Sampling without replacement was used to obtain a probability of herd detection of paratuberculosis for each evaluated sampling method and for simulated sample sizes between 30 and 150 cows. Marginal cost-effectiveness analysis was used to determine the cost increase relative to the increase in detection probability.
  
  
  RESULTS
  Sampling cows in the third or higher lactation and > or = 200 days into lactation yielded the highest detection probability in most instances, resulting in a detection probability that was 1.4 to 2.5 times that obtained by sampling 30 cows in the second or higher lactation. Costs of testing via the alternative method with a 95% detection probability were approximately dollar 300 lower in a high-prevalence herd (31%) and dollar 800 lower in a low-prevalence herd (9%), compared with use of the reference method.
  
  
  CONCLUSIONS
  Detection of herds with paratuberculosis could be improved, and costs of testing substantially reduced by sampling targeted groups of cows.
authors.affiliation: Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.
authors.forename: Saraya
authors.initials: S
authors.lastname: Tavornpanich
authors.forename: Ian A
authors.initials: IA
authors.lastname: Gardner
authors.forename: Tim E
authors.initials: TE
authors.lastname: Carpenter
authors.forename: Wesley O
authors.initials: WO
authors.lastname: Johnson
authors.forename: Randall J
authors.initials: RJ
authors.lastname: Anderson
mesh_terms: D000818:Animals; D002417:Cattle; D002418:Cattle Diseases / Q000175:diagnosis* / Q000191:economics* / Q000453:epidemiology / Q000382:microbiology; D003362:Cost-Benefit Analysis; D003612:Dairying / Q000191:economics* / Q000379:methods*; D005260:Female; D009010:Monte Carlo Method; D016927:Mycobacterium avium subsp. paratuberculosis / Q000302:isolation & purification*; D010283:Paratuberculosis / Q000175:diagnosis* / Q000191:economics* / Q000453:epidemiology / Q000382:microbiology; D015995:Prevalence