Badea, A; Reeder, B; Groot, G; Muhajarine, N; Minion, J; Miller, L; Howell-Spooner, B. In real world settings, what is the validity of Rapid Antigen Tests (RATs) in identifying SARS-CoV-2 and how well do they predict disease? 2022 Jan 12, Document no.: EOC211201 RR Table. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2022. (CEST table).
The diagnostic accuracy of Rapid Antigen Tests (RAT) has been widely studied in various applications and in diverse populations.
Sensitivity, in the order of 75% in pooled estimates, is significantly influenced by the presence or absence of symptoms, viral load, and the timing of sampling relative to the onset of symptoms.
Specificity, in the order of 99% in pooled estimates, is consistently high across tests, populations, and sampling methods.
Post-test probability of being an infectious case following a positive test is highest in individuals with a high pre-test probability (population prevalence > 5%), such as those with COVID-19 symptoms, and those in settings with a high level of community transmission. Here, the positive predictive value is in the order of 95%. However, when used in settings with a lower pre-test probability (population prevalence < 0.5%), as in screening asymptomatic individuals, the positive predictive value is considerably reduced, as low as 25%.
Post-test probability of being an infectious case following a negative test is less than 1% (negative predictive value > 99%) in all settings except those with the highest levels of community transmission.
Badea, A; Reeder, B; Groot, G; Muhajarine, N; Minion, J; Miller, L; Howell-Spooner, B. In real world settings, what is the validity of Rapid Antigen Tests (RATs) in identifying SARS-CoV-2 and how well do they predict disease? 2022 Jan 12, Document no.: EOC211201 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2022. 15 p. (CEST rapid review report).
Miller, L. & Howell-Spooner, B. In real world settings, what is the validity of RATs in identifying COVID-19 (sensitivity, specificity), and how well do they predict disease (positive and negative predictive values)? 2021 Dec 29, Document no.: EOC211201 ESR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2021. 56 p. (CEST evidence search report).
Miller, Lukas. Howell-Spooner, Brianna. Omicron Variant: In real world settings, what is the validity of RATs in identifying COVID-19 (sensitivity, specificity), and how well do they predict disease (positive and negative predictive values)? 2022 Jan 05. Document no.: EOC211201-02 ESR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2022. 12 p. (CEST rapid review report).
Dalidowicz, M; Ellsworth, C. What COVID-19 community transmission indicators are used in school reopening plans? 2020 Aug 12; Document no.: EOC081201-01 ESR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 12 p. (CEST evidence search report)
· Potential impact on reproductive rate (R) of the seven “returning to school” scenarios that were modeled by SAGE exhibited an increase in R due to reopening of school. The scale of increase depended on current value of R within each community and mitigation plans within the community, especially the adherence to social distancing measures. · CDC recommended using additional indicators such as healthcare capacity, new cases, and percent of positive cases to decide school operations along with community spread levels: none-to-minimal, minimal-to-moderate, substantial-controlled, and substantial-uncontrolled. · Combination of strategies such as mask usage, physical distancing, hygiene measures, classroom cohorting, symptomatic screening, testing and tracing of students, staff and teachers along with low levels of community transmission can aid in maintaining low level of R. · Increasing testing and contract tracing can impede an epidemic rebound. · Intersectoral partnerships with local authorities, dedicated personnel (such as coordinators) for testing and tracing along with appropriate communication with parents, teachers and staff should be followed to open schools safely.
Pisolkar, V; McRae, D; Muhajarine, N; Dalidowicz, M; Ellsworth, C. What COVID community transmission indicators are used in school reopening plans? 2020 Aug 26; Document no.: EOC081201 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 23 p. (CEST rapid review report)
Howell-Spooner, B. What frequency of repeat population screening will be required? 2020 Apr 23; Document no.: LAB042202-01 ESR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 40 p. (CEST evidence search report)
Low grade evidence suggests that SARS-CoV-2 may persist within a population and lead to recrudescent outbreaks in winter months which may include the re-infection of previously infected individuals.
· Population monitoring by means of repeated cross-sectional surveys and/or longitudinal cohort studies is strongly advised by WHO
Wang, H; Reeder, B; Howell-Spooner, B. What frequency of repeat population screening will be required? 2020 Apr 25; Document no.: LAB042202 RR. In: COVID19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020.
4 p. (CEST rapid review report)
Duncan, V. What sampling method is most appropriate for population testing? 2020 Apr 23; Document no.: LAB042201-01 ESR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 14 p. (CEST evidence search report)
For COVID-19 there are no published data to identify optimal population sampling methods, however, a population-based sample in which testing is performed for both rt-PCR and serology might be recommended. There are also opportunities to examine innovative sampling strategies being used in pilot studies underway in other jurisdictions.
Vanstone, J; Reeder, B; Duncan, V. What sampling method is most appropriate for population testing? 2020 Apr 23; Document no.: LAB042201 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 5 p. (CEST rapid review report)
