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A systematic review of the sensitivity and specificity of lateral flow devices in the detection of SARS-CoV-2.
Mistry, Dylan A; Wang, Jenny Y; Moeser, Mika-Erik; Starkey, Thomas; Lee, Lennard Y W.
  • Mistry DA; Oxford University Hospitals, Headley Way, Headington, Oxford, OX3 9DU, UK. dylan.mistry@nhs.net.
  • Wang JY; University of Oxford, Oxford, UK.
  • Moeser ME; University of Oxford, Oxford, UK.
  • Starkey T; Institute of Cancer and Genomic Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
  • Lee LYW; Oxford University Hospitals, Headley Way, Headington, Oxford, OX3 9DU, UK.
BMC Infect Dis ; 21(1): 828, 2021 Aug 18.
Article in English | MEDLINE | ID: covidwho-1365326
ABSTRACT

BACKGROUND:

Lateral flow devices (LFDs) are viral antigen tests for the detection of SARS-CoV-2 that produce a rapid result, are inexpensive and easy to operate. They have been advocated for use by the World Health Organisation to help control outbreaks and break the chain of transmission of COVID-19 infections. There are now several studies assessing their accuracy but as yet no systematic review. Our aims were to assess the sensitivity and specificity of LFDs in a systematic review and summarise the sensitivity and specificity of these tests.

METHODS:

A targeted search of Pubmed and Medxriv, using PRISMA principles, was conducted identifying clinical studies assessing the sensitivity and specificity of LFDs as their primary outcome compared to reverse transcriptase polymerase chain reaction (RT-PCR) for the detection of SARS-CoV-2. Based on extracted data sensitivity and specificity was calculated for each study. Data was pooled based on manufacturer of LFD and split based on operator (self-swab or by trained professional) and sensitivity and specificity data were calculated.

RESULTS:

Twenty-four papers were identified involving over 26,000 test results. Sensitivity from individual studies ranged from 37.7% (95% CI 30.6-45.5) to 99.2% (95% CI 95.5-99.9) and specificity from 92.4% (95% CI 87.5-95.5) to 100.0% (95% CI 99.7-100.0). Operation of the test by a trained professional or by the test subject with self-swabbing produced comparable results.

CONCLUSIONS:

This systematic review identified that the performance of lateral flow devices is heterogeneous and dependent on the manufacturer. Some perform with high specificity but a great range of sensitivities were shown (38.32-99.19%). Test performance does not appear dependent on the operator. Potentially, LFDs could support the scaling up of mass testing to aid track and trace methodology and break the chain of transmission of COVID-19 with the additional benefit of providing individuals with the results in a much shorter time frame.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Testing / SARS-CoV-2 / COVID-19 Type of study: Diagnostic study / Observational study / Prognostic study / Reviews / Systematic review/Meta Analysis Limits: Female / Humans / Male Language: English Journal: BMC Infect Dis Journal subject: Communicable Diseases Year: 2021 Document Type: Article Affiliation country: S12879-021-06528-3

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Testing / SARS-CoV-2 / COVID-19 Type of study: Diagnostic study / Observational study / Prognostic study / Reviews / Systematic review/Meta Analysis Limits: Female / Humans / Male Language: English Journal: BMC Infect Dis Journal subject: Communicable Diseases Year: 2021 Document Type: Article Affiliation country: S12879-021-06528-3