Interpretation of Lyme Disease Tests Shows Variability
Accurate interpretation of Lyme disease diagnostics remains inconsistent across laboratories, a new study shows, highlighting the need for harmonized standards and enhanced clinician training.
Web-Based Evaluation of Lyme Diagnostics
Researchers conducted an external quality assessment using a web-based survey among 38 medical microbiology laboratories. Each laboratory interpreted 20 simulated Lyme borreliosis cases that included patient histories and laboratory findings. Participants provided both open-ended interpretations and likelihood ratings of active infection. Six Lyme diagnostics experts reviewed the responses to establish a performance baseline and scored results on a scale from one to ten.
Results Reveal Strong but Uneven Diagnostic Interpretation
The mean score across all participating laboratories was 8.8, indicating generally sound interpretive performance. However, the results revealed considerable variability depending on case type. For multiple-choice questions, participants averaged 9.6, suggesting a high level of agreement when structured guidance was provided. In contrast, open-ended interpretations yielded a lower mean of 8.0, with the weakest results seen in rare or low-incidence Lyme disease presentations.
Training and AI Could Improve Consistency
The findings underscore the importance of standardized interpretation protocols and targeted education for laboratory specialists and clinicians. The authors suggest that future harmonization efforts across Europe could benefit from structured training and artificial intelligence, based clinical support systems. Such tools may help improve diagnostic accuracy and reduce variation in interpreting Lyme disease test results, particularly for atypical or complex cases.
Reference: Hoeve-Bakker BJA et al. Towards harmonization of Lyme diagnostics interpretation: external quality assessment using a web-based survey. Eur J Clin Microbiol Infect Dis. 2025; doi:10.1007/s10096-025-05315-1.
