Summary. Background and aim: Testing represents one of the main pillars of public health response to SARS-CoV-2/COVID-19 pandemic. This paper shows how accuracy and utility of testing programs depend not just on the type of tests, but on the context as well. Methods: We describe the testing methods that have been developed and the possible testing strategies; then, we focus on two possible methods of population-wide testing, i.e., pooled testing and testing with rapid antigen tests. We show the accuracy of split-pooling method and how, in different pre-test probability scenarios, the positive and negative predictive values vary using rapid antigen tests. Results: Split-pooling, followed by retesting of negative results, shows a higher sensitivity than individual testing and requires fewer tests. In case of low pre-test probability, a negative result with antigen test could allow to rule out the infection, while, in case of a positive result, a confirmatory molecular test would be necessary. Conclusions: Test performance alone is not enough to properly choose which test to use; goals and context of the testing program are essential. We advocate the use of pooled strategies when planning population-wide screening, and the weekly use of rapid tests for close periodic monitoring in low-prevalence populations. (www.actabiomedica.it).

SARS-CoV-2/COVID-19 testing: The tower of babel / Reno C.; Lenzi J.; Golinelli D.; Gori D.; Signorelli C.; Kraemer J.; Stoto M.A.; Avitabile E.; Landini M.P.; Lazzarotto T.; Re M.C.; Rucci P.; Taliani G.; Trere' D.; Vocale C.; Fantini M.P.. - In: ACTA BIO-MEDICA DE L'ATENEO PARMENSE. - ISSN 0392-4203. - ELETTRONICO. - 91:4(2020), pp. 1-10. [10.23750/abm.v91i4.10911]

SARS-CoV-2/COVID-19 testing: The tower of babel

Reno C.;Lenzi J.
;
Golinelli D.;Gori D.;Avitabile E.;Landini M. P.;Lazzarotto T.;Re M. C.;Rucci P.;Taliani G.;Trere' D.;Vocale C.;Fantini M. P.
2020

Abstract

Summary. Background and aim: Testing represents one of the main pillars of public health response to SARS-CoV-2/COVID-19 pandemic. This paper shows how accuracy and utility of testing programs depend not just on the type of tests, but on the context as well. Methods: We describe the testing methods that have been developed and the possible testing strategies; then, we focus on two possible methods of population-wide testing, i.e., pooled testing and testing with rapid antigen tests. We show the accuracy of split-pooling method and how, in different pre-test probability scenarios, the positive and negative predictive values vary using rapid antigen tests. Results: Split-pooling, followed by retesting of negative results, shows a higher sensitivity than individual testing and requires fewer tests. In case of low pre-test probability, a negative result with antigen test could allow to rule out the infection, while, in case of a positive result, a confirmatory molecular test would be necessary. Conclusions: Test performance alone is not enough to properly choose which test to use; goals and context of the testing program are essential. We advocate the use of pooled strategies when planning population-wide screening, and the weekly use of rapid tests for close periodic monitoring in low-prevalence populations. (www.actabiomedica.it).
2020
SARS-CoV-2/COVID-19 testing: The tower of babel / Reno C.; Lenzi J.; Golinelli D.; Gori D.; Signorelli C.; Kraemer J.; Stoto M.A.; Avitabile E.; Landini M.P.; Lazzarotto T.; Re M.C.; Rucci P.; Taliani G.; Trere' D.; Vocale C.; Fantini M.P.. - In: ACTA BIO-MEDICA DE L'ATENEO PARMENSE. - ISSN 0392-4203. - ELETTRONICO. - 91:4(2020), pp. 1-10. [10.23750/abm.v91i4.10911]
Reno C.; Lenzi J.; Golinelli D.; Gori D.; Signorelli C.; Kraemer J.; Stoto M.A.; Avitabile E.; Landini M.P.; Lazzarotto T.; Re M.C.; Rucci P.; Taliani G.; Trere' D.; Vocale C.; Fantini M.P.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/794252
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