Modified Two-Tiered Testing Enzyme Immunoassay Algorithm for Serologic Diagnosis of Lyme Disease

The modified 2-tier testing algorithm (MTTT) for Lyme disease (LD) has been approved by the US Food and Drug Administration. In this study, we show that the MTTT detected 28% more cases of early infection compared with the standard 2-tier algorithm while retaining high specificity in a region with a high incidence of LD. In this study, we show that the modified 2-tier testing algorithm for Lyme disease approved by the US Food and Drug Administration detected 28% more cases of early infection compared with the standard 2-tier algorithm while retaining high specificity.