Diagnostic Accuracy of Rapid Antigen Tests for COVID-19 Detection: A Systematic Review With Meta-analysis
Open Access
- 7 April 2022
- journal article
- review article
- Published by Frontiers Media SA in Frontiers in Medicine
- Vol. 9, 870738
- https://doi.org/10.3389/fmed.2022.870738
Abstract
Introduction: Reverse transcription-polymerase chain reaction (RT-PCR) to detect SARS-CoV-2 is time-consuming and sometimes not feasible in developing nations. Rapid antigen test (RAT) could decrease the load of diagnosis. However, the efficacy of RAT is yet to be investigated comprehensively. Thus, the current systematic review and meta-analysis were conducted to evaluate the diagnostic accuracy of RAT against RT-PCR methods as the reference standard. Methods: We searched the MEDLINE/Pubmed and Embase databases for the relevant records. The QUADAS-2 tool was used to assess the quality of the studies. Diagnostic accuracy measures [i.e., sensitivity, specificity, diagnostic odds ratio (DOR), positive likelihood ratios (PLR), negative likelihood ratios (NLR), and the area under the curve (AUC)] were pooled with a random-effects model. All statistical analyses were performed with Meta-DiSc (Version 1.4, Cochrane Colloquium, Barcelona, Spain). Results: After reviewing retrieved records, we identified 60 studies that met the inclusion criteria. The pooled sensitivity and specificity of the rapid antigen tests against the reference test (the real-time PCR) were 69% (95% CI: 68–70) and 99% (95% CI: 99–99). The PLR, NLR, DOR and the AUC estimates were found to be 72 (95% CI: 44–119), 0.30 (95% CI: 0.26–0.36), 316 (95% CI: 167–590) and 97%, respectively. Conclusion: The present study indicated that using RAT kits is primarily recommended for the early detection of patients suspected of having COVID-19, particularly in countries with limited resources and laboratory equipment. However, the negative RAT samples may need to be confirmed using molecular tests, mainly when the symptoms of COVID-19 are present.This publication has 102 references indexed in Scilit:
- Evaluation of a Rapid Diagnostic Assay for Detection of SARS-CoV-2 Antigen in Nasopharyngeal SwabsJournal of Clinical Microbiology, 2020
- Diagnostic value and dynamic variance of serum antibody in coronavirus disease 2019International Journal of Infectious Diseases, 2020
- Decay of infectious adenovirus and coliphages in freshwater habitats is differentially affected by ambient sunlight and the presence of indigenous protozoa communitiesVirology Journal, 2020
- Understanding the properties of diagnostic tests – Part 2: Likelihood ratiosPerspectives in Clinical Research, 2018
- QUADAS-2: A Revised Tool for the Quality Assessment of Diagnostic Accuracy StudiesAnnals of Internal Medicine, 2011
- Measures of Diagnostic Accuracy: Basic Definitions2009
- Twenty-five years of quantitative PCR for gene expression analysisBioTechniques, 2008
- The performance of tests of publication bias and other sample size effects in systematic reviews of diagnostic test accuracy was assessedJournal of Clinical Epidemiology, 2005
- Conducting systematic reviews of diagnostic studies: didactic guidelinesBMC Medical Research Methodology, 2002