BACKGROUND: The use of rapid antigen tests to triage specimens for polymerase chain reaction (PCR) testing from emergency department patients with influenza-like illness during surveillance for novel influenza viruses has been suggested. OBJECTIVE: To measure the observed sensitivity and specificity for a widely used rapid antigen test (Binax) using a PCR-based assay (Medical Diagnostic Laboratories). METHODS: Nasopharyngeal samples were taken with flocked swabs (Copan Diagnostics) from patients presenting to the emergency department of a community hospital. Samples were analysed using a rapid antigen and a PCR-based test. PCR testing was used as the criterion reference. Sensitivity and specificity were calculated for influenza and influenza A. Positive predictive values were calculated over a range of possible prevalence. RESULTS: Samples from 566 unique patients were tested using both methods. Sensitivity was 69.1% (95% CI 58.9% to 78.1%) and specificity was 97.7% (95% CI 95.8% to 98.8%) for the detection of any influenza and 75.3% (95% CI 64.7% to 84.0%) and 97.8% (95% CI 95.9% to 98.9%), respectively, for influenza A only. The resultant positive predictive value ranges from 23% to 77% when the prevalence ranges from 1% to 10%. CONCLUSION: When planning early outbreak surveillance, provision of adequate PCR testing capacity rather than triaging specimens using rapid antigen testing for influenza is advisable.
BACKGROUND: The use of rapid antigen tests to triage specimens for polymerase chain reaction (PCR) testing from emergency department patients with influenza-like illness during surveillance for novel influenza viruses has been suggested. OBJECTIVE: To measure the observed sensitivity and specificity for a widely used rapid antigen test (Binax) using a PCR-based assay (Medical Diagnostic Laboratories). METHODS: Nasopharyngeal samples were taken with flocked swabs (Copan Diagnostics) from patients presenting to the emergency department of a community hospital. Samples were analysed using a rapid antigen and a PCR-based test. PCR testing was used as the criterion reference. Sensitivity and specificity were calculated for influenza and influenza A. Positive predictive values were calculated over a range of possible prevalence. RESULTS: Samples from 566 unique patients were tested using both methods. Sensitivity was 69.1% (95% CI 58.9% to 78.1%) and specificity was 97.7% (95% CI 95.8% to 98.8%) for the detection of any influenza and 75.3% (95% CI 64.7% to 84.0%) and 97.8% (95% CI 95.9% to 98.9%), respectively, for influenza A only. The resultant positive predictive value ranges from 23% to 77% when the prevalence ranges from 1% to 10%. CONCLUSION: When planning early outbreak surveillance, provision of adequate PCR testing capacity rather than triaging specimens using rapid antigen testing for influenza is advisable.
Authors: H Rogier van Doorn; Nguyen van Kinh; Ha Manh Tuan; Tran Anh Tuan; Ngo Ngoc Quang Minh; Juliet E Bryant; Vu thi Ty Hang; Le thi Tham Uyen; Le Quoc Thinh; Tran thi Ngoc Anh; Nguyen Phu Huong Lan; Nguyen Vu Trung; Walter Taylor; Laura Merson; Heiman F L Wertheim; Jeremy Farrar; Marcel Wolbers; Nguyen van Vinh Chau; Menno D de Jong Journal: J Clin Microbiol Date: 2012-02-22 Impact factor: 5.948
Authors: Won Suk Choi; Ji Yun Noh; Yu Bin Seo; Ji Hyeon Baek; Jacob Lee; Joon Young Song; Dae Won Park; Jin Soo Lee; Hee Jin Cheong; Woo Joo Kim Journal: Clin Vaccine Immunol Date: 2013-04-10
Authors: Won Suk Choi; Ji Yun Noh; Joong Yeon Huh; Sae Yoon Kee; Hye Won Jeong; Jacob Lee; Joon Young Song; Hee Jin Cheong; Woo Joo Kim Journal: Yonsei Med J Date: 2011-07 Impact factor: 2.759
Authors: Won Suk Choi; Ji Yun Noh; Ji Hyeon Baek; Yu Bin Seo; Jacob Lee; Joon Young Song; Dae Won Park; Jin Soo Lee; Hee Jin Cheong; Woo Joo Kim Journal: PLoS One Date: 2015-03-27 Impact factor: 3.240