Imperial College London
Alternate

Professor Nimalan Arinaminpathy (Nim Pathy)

Faculty of Medicine, School of Public Health

Professor in Mathematical Epidemiology
 
 
 
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Contact

 

nim.pathy Website

 
 
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Location

 

Praed StreetSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Ricks:2021:10.1186/s12916-021-01948-z,
author = {Ricks, S and Kendall, EA and Dowdy, DW and Sacks, JA and Schumacher, SG and Arinaminpathy, N},
doi = {10.1186/s12916-021-01948-z},
journal = {BMC Medicine},
pages = {1--13},
title = {Quantifying the potential value of antigen-detection rapid diagnostic tests for COVID-19: a modelling analysis},
url = {http://dx.doi.org/10.1186/s12916-021-01948-z},
volume = {19},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundTesting plays a critical role in treatment and prevention responses to the COVID-19 pandemic. Compared to nucleic acid tests (NATs), antigen-detection rapid diagnostic tests (Ag-RDTs) can be more accessible, but typically have lower sensitivity and specificity. By quantifying these trade-offs, we aimed to inform decisions about when an Ag-RDT would offer greater public health value than reliance on NAT. MethodsFollowing an expert consultation, we selected two use cases for analysis: rapid identification of people with COVID-19 amongst patients admitted with respiratory symptoms in a ‘hospital’ setting; and early identification and isolation of people with mildly symptomatic COVID-19 in a ‘community’ setting. Using decision analysis, we evaluated the health system cost and health impact (deaths averted and infectious days isolated) of an Ag-RDT-led strategy, compared to a strategy based on NAT and clinical judgment. We adopted a broad range of values for ‘contextual’ parameters relevant to a range of settings, including the availability of NAT, the performance of clinical judgement, etc. We performed a multivariate sensitivity analysis to all of these parameters.  ResultsIn a hospital setting, an Ag-RDT-led strategy would avert more deaths than a NAT-based strategy, and at lower cost per death averted, when the sensitivity of clinical judgement is less than 85%, and when NAT results are available in time to inform clinical decision-making for less than 90% of patients. The use of an Ag-RDT is robustly supported in community settings, where it would avert more transmission at lower cost than relying on NAT alone, under a wide range of assumptions. ConclusionsDespite their imperfect sensitivity and specificity, Ag-RDTs have the potential to be simultaneously more impactful, and have a lower cost per death and infectious person-days averted, than current approaches to COVID-19 diagnostic testing.
AU  - Ricks,S
AU  - Kendall,EA
AU  - Dowdy,DW
AU  - Sacks,JA
AU  - Schumacher,SG
AU  - Arinaminpathy,N
DO  - 10.1186/s12916-021-01948-z
EP  - 13
PY  - 2021///
SN  - 1741-7015
SP  - 1
TI  - Quantifying the potential value of antigen-detection rapid diagnostic tests for COVID-19: a modelling analysis
T2  - BMC Medicine
UR  - http://dx.doi.org/10.1186/s12916-021-01948-z
UR  - https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-021-01948-z
UR  - http://hdl.handle.net/10044/1/86189
VL  - 19
ER  -
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