HUGE Systematic review and meta-analysis of point-of-care serological tests for COVID-19 antibodies "Currently, available evidence does not support the continued use of existing point-of-care serological tests"pic.twitter.com/TKg4SdK0u6
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The problem for many serosurveys is that they used ELISA tests for IgG. According to this study, the pooled estimate for specificity of these tests is 98.9% and sensitivity of 80.6%
Now in a population with a 10% prevalence, that's pretty bad. In 1000 people, you miss 20 true positives and get 10 false positives, so you underestimate prevalence substantially
Conversely, if you have 1% prevalence, you miss 2 true positives but get 11 false ones, so you overestimate the prevalence of COVID infections enormously This is a big problem!
Now, some serosurveys have corrected for issues like this, but these new results suggest that commercial tests are less reliable and that their figures are more likely to be wrong That's a worry
Also, apologies, the initial tweet was incorrect - this SR/MA was for ALL serology tests for COVID-19 not just POC ones
I'm not going to elevate this b/c people will misunderstand it. But it supports the contention that at present SARS-CoV-2 antibody testing isn't particularly useful *at the individual level* for a number of reasons. However, it doesn't obviate its utility at the population level.
Oh I disagree. Given the sens/spec issues and the problems with generalisability I think this is in some ways more worrisome for population testing efforts than for the individual
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