Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 30, Number 2—February 2024
Research Letter

Model for Interpreting Discordant SARS-CoV-2 Diagnostic Test Results

Oluwaseun F. Egbelowo1, Spencer J. Fox1, Graham C. Gibson, and Lauren Ancel MeyersComments to Author 
Author affiliations: The University of Texas at Austin, Austin, Texas, USA (O.F. Egbelowo, L.A. Meyers); University of Georgia, Athens, Georgia, USA (S.J. Fox); Los Alamos National Laboratory, Los Alamos, New Mexico, USA (G.C. Gibson); Santa Fe Institute, Santa Fe, New Mexico, USA (L.A. Meyers)

Main Article

Table

Probability that a RAT is false-positive in a model for interpreting discordant SARS-CoV-2 diagnostic test results*

No. days between RAT and NAAT Estimated RAT false-positive rate, % (95% CI)
0 73.4 (49.2–100)
1 82.5 (63.4–100)
2 88 (73.3–100)
3 89.2 (75.9–100)
4 89.6 (76.6–100)
5 88.8 (75.0–100)
6 88.4 (74.1–100)
7 86.7 (71–100)

*The model assumes that a NAAT was negative after a RAT and that NAAT was performed after specified time delay. Estimates assume that the antigen test was performed when patient symptoms first appeared and had a test sensitivity of 84.6% and specificity of 98.54%, which corresponds to the estimated values for BinaxNOW (Abbott Laboratories, https://www.abbott.com) (Appendix Table 1). The NAAT false negative rate for each delay was drawn from a previous study (3). NAAT, nucleic acid amplification test; RAT, rapid antigen test.

Main Article

References
  1. Wong  G, Liu  W, Liu  Y, Zhou  B, Bi  Y, Gao  GF. MERS, SARS, and Ebola: the role of super-spreaders in infectious disease. Cell Host Microbe. 2015;18:398–401. DOIPubMedGoogle Scholar
  2. Kucirka  LM, Lauer  SA, Laeyendecker  O, Boon  D, Lessler  J. Variation in false-negative rate of reverse transcriptase polymerase chain reaction–based SARS-CoV-2 tests by time since exposure. Ann Intern Med. 2020;173:262–7. DOIPubMedGoogle Scholar
  3. Yang  S, Rothman  RE. PCR-based diagnostics for infectious diseases: uses, limitations, and future applications in acute-care settings. Lancet Infect Dis. 2004;4:337–48. DOIPubMedGoogle Scholar
  4. Schuit  E, Veldhuijzen  IK, Venekamp  RP, van den Bijllaardt  W, Pas  SD, Lodder  EB, et al. Diagnostic accuracy of rapid antigen tests in asymptomatic and presymptomatic close contacts of individuals with confirmed SARS-CoV-2 infection: cross sectional study. BMJ. 2021;374:n1676. DOIPubMedGoogle Scholar
  5. Filgueiras  PS, Corsini  CA, Almeida  NBF, Assis  JV, Pedrosa  MLC, de Oliveira  AK, et al. COVID-19 rapid antigen test at hospital admission associated to the knowledge of individual risk factors allow overcoming the difficulty of managing suspected patients in hospitals. Fortune J Health Sci. 2022;5:211–31. DOIGoogle Scholar
  6. Gans  JS, Goldfarb  A, Agrawal  AK, Sennik  S, Stein  J, Rosella  L. False-positive results in rapid antigen tests for SARS-CoV-2. JAMA. 2022;327:485–6. DOIPubMedGoogle Scholar
  7. Kanji  JN, Proctor  DT, Stokes  W, Berenger  BM, Silvius  J, Tipples  G, et al. Multicenter postimplementation assessment of the positive predictive value of SARS-CoV-2 antigen-based point-of-care tests used for screening of asymptomatic continuing care staff. J Clin Microbiol. 2021;59:e0141121. DOIPubMedGoogle Scholar
  8. Centers for Disease Control and Prevention; National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral Diseases. Science brief: indicators for monitoring COVID-19 community levels and making public health recommendations. In: CDC COVID-19 science briefs. Atlanta (GA): Centers for Disease Control and Prevention (US); 2022.
  9. Centers for Disease Control and Prevention. Estimated COVID-19 burden [cited 2022 May 25]. https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burden.html
  10. Osterman  A, Badell  I, Basara  E, Stern  M, Kriesel  F, Eletreby  M, et al. Impaired detection of omicron by SARS-CoV-2 rapid antigen tests. Med Microbiol Immunol (Berl). 2022;211:105–17. DOIPubMedGoogle Scholar

Main Article

1These first authors contributed equally to this article.

Page created: December 19, 2023
Page updated: January 24, 2024
Page reviewed: January 24, 2024
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external