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Table 1 Diagnostic classification of reference reader results used to establish accepted composite diagnosis and identify unqualified readers

From: Production and validation of durable, high quality standardized malaria microscopy slides for teaching, testing and quality assurance during an era of declining diagnostic proficiency

Level of Diagnosis

Reported Diagnosis

Variable

Composite Diagnosis

Misdiagnosis Demerit Points

Primary

Plasmodia positive or negative

Dichotomous

Agreement >80%

10: false positive

5: false negative

Secondary

Species

Discontinuous (Pf, Pv, Pm, Po)*

Agreement >80% for mono-infection

Agreement >50% for mixed infection**

3: infection misclassified

Tertiary

Parasite Count

Continuous

Median count

1: parasite density outside 99% CI

  1. * Pf = Plasmodium falciparum, Pv = P. vivax, Pm = P. malariae, Po = P. ovale, includes any combination of these species
  2. ** or less than 50% with PCR confirmation