An identifiability problem in a state model for partly undetected chronic diseases

Recently, we proposed an state model (compartment model) to describe the progression of a chronic disease with an pre-clinical (undiagnosed) state before clinical diagnosis. It is an open question, if a sequence of cross-sectional studies with mortality follow-up is sufficient to estimate the true incidence rate of the disease, i.e. the incidence of the undiagnosed and diagnosed disease. In this note, we construct a counterexample and show that this cannot be achieved in general.