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Performance of Existing and Novel Symptom- and Antigen Testing-Based COVID-19 Case Definitions in a Community Setting.
Lee, Scott; Almendares, Olivia; Prince-Guerra, Jessica; Anderson, Mark; Heilig, Charles M; Tate, Jacqueline E; Kirking, Hannah L.
  • Lee S; Center for Surveillance, Epidemiology, and Laboratory Services (CSELS), CDC.
  • Almendares O; COVID-19 Response Team, CDC.
  • Prince-Guerra J; COVID-19 Response Team, CDC.
  • Anderson M; Laboratory Leadership Service.
  • Heilig CM; COVID-19 Response Team, CDC.
  • Tate JE; Center for Surveillance, Epidemiology, and Laboratory Services (CSELS), CDC.
  • Kirking HL; COVID-19 Response Team, CDC.
Am J Epidemiol ; 2022 Nov 07.
Article in English | MEDLINE | ID: covidwho-2268323
ABSTRACT
Point-of-care antigen tests are an important tool for SARS-CoV-2 detection yet are less clinically sensitive than real-time reverse-transcription PCR (RT-PCR), impacting their efficacy as screening procedures. Our goal in this analysis was to see whether we could improve this sensitivity by considering antigen test results in combination with other relevant information, namely exposure status and reported symptoms. In November of 2020, we collected 3,419 paired upper respiratory specimens tested by RT-PCR and the Abbott BinaxNOW antigen test at two community testing sites in Pima County, Arizona. We used symptom, exposure, and antigen testing data to evaluate the sensitivity and specificity of various symptom definitions in predicting RT-PCR positivity. Our analysis yielded 6 novel multi-symptom case definitions with and without antigen test results, the best of which overall achieved a Youden's J index of 0.66, as compared with 0.53 for antigen testing alone. Using a random forest as a guide, we show that this definition, along with our others, does not lose the ability to generalize well to new data despite achieving optimal performance in our sample. Our methodology is broadly applicable, and our code is publicly available to aid public health practitioners in developing or fine-tuning their own case definitions.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Diagnostic study / Experimental Studies / Prognostic study / Randomized controlled trials Language: English Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Diagnostic study / Experimental Studies / Prognostic study / Randomized controlled trials Language: English Year: 2022 Document Type: Article