I-STOD: a new standardization method for analysing indirect-ELISA results of a schistosomiasis field study.

Variability among samples analysed using the same ELISA protocol generates ambiguity in deciding which assay best quantifies the protein concentration. In this study, we propose a standardization method, called I-STOD (Improved STandardization method for Optical Density), for the transformation of OD values on different plates into relative concentrations of the antibody levels being assessed. We derived an equation relating OD values of different test samples to antibody levels according to the multi-stage reaction dynamics of the indirect-ELISA. Using serum samples from a Schistosomiasis japonica endemic area, we evaluated the fitness of the I-STOD model to experimental data of a standard reference serum in comparison with 5 other models. Calibration curves fitted by the I-STOD method judged to be superior, based on adjusted R2 (adjusted R2>0.99 on 22 out of 26 plates) values. The CV (coefficient of variation) value of the results between multi-well plates and the number of plates with OD values beyond the control range in Shewhart charts also demonstrate that the I-STOD method is a powerful tool which can greatly improve the comparability of results on different multi-well ELISA plates. We conclude that a standardization method is certainly necessary for antibody levels detected in order to properly illustrate clinical differences.