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Brian S. Schwartz, MD, MS; Michael D. Goldstein, MD, MPH; Jose M. C. Ribeiro, MD, PhD; Terry L. Schulze, PhD; S. I. Shahied, PhD

JAMA. 1989;262(24):3431-3434.

Abstract
To evaluate the interlaboratory and intralaboratory agreement in the performance of Lyme disease serological testing, we sent serum specimens from 132 outdoor workers in New Jersey to as many as four independent laboratories. These included one state department of health laboratory, one large commercial laboratory, and two research laboratories. The measurement of agreement employed, the kappa statistic, ranged from.45 to.53 among the four laboratories and from.50 to.54 within the commercial laboratory. These values represent low levels of agreement. The data suggest that Lyme disease serological testing procedures should be standardized so that Lyme disease test results are more comparable between laboratories.

(JAMA. 1989;262:3431-3434)

Author Affiliations
From the Clinical Epidemiology Unit, Section of General Internal Medicine, University of Pennsylvania, Philadelphia (Dr Schwartz); the Center for Occupational Medicine, New Jersey Department of Environmental Protection, Trenton (Dr Goldstein); the Department of Tropical Public Health, Harvard School of Public Health, Boston, Mass (Dr Ribeiro); and the New Jersey State Department of Health, Trenton (Drs Schulze and Shahied). Dr Schwartz is now with the Division of Occupational Medicine, The Johns Hopkins University School of Hygiene and Public Health, Baltimore, Md.

Footnotes
Reprint requests to Center for Occupational Medicine, Department of Environmental Protection, 401 E State St, Trenton, NJ 08625 (Dr Goldstein).

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