The importance of disease prevalence in clinical decision making: a real practice study on COVID-19 antigen test in Curacao
The performance of a test can be suboptimal, but in appropriate setting such a test is still useful for clinical decision making. We investigated the role of Antigen Rapid Diagnostic Test (Ag-RDT) for clinical decision making in an Emergency Department (ED) in Curacao during peak of COVID-19 pandemi...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-07-01
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| Series: | Brazilian Journal of Infectious Diseases |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1413867022000769 |
| _version_ | 1818495292972990464 |
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| author | Erlangga Yusuf Liane Virginia-Cova Lisette B Provacia Jeanne Koeijers Vanessa Brown |
| author_facet | Erlangga Yusuf Liane Virginia-Cova Lisette B Provacia Jeanne Koeijers Vanessa Brown |
| author_sort | Erlangga Yusuf |
| collection | DOAJ |
| description | The performance of a test can be suboptimal, but in appropriate setting such a test is still useful for clinical decision making. We investigated the role of Antigen Rapid Diagnostic Test (Ag-RDT) for clinical decision making in an Emergency Department (ED) in Curacao during peak of COVID-19 pandemic. Ag-RDT was performed in the naso- and oropharynx-swabs from patients with respiratory insufficiency presented to the ED. Ag-RDT was performed in 153 patients, of which 64 (41.8%) showed positive results. Comparing Ag-RDT results with molecular tests, its sensitivity was 68.8% (95% CI 57.4 to 78.7), and specificity of 94.6% (95% CI 84.9 to 98.9). The positive and negative predictive value were 95.1% (95% CI 86.5 to 98.3) and 66.3 (95% CI 58.6 to 73.3), respectively. All patients with Ag-RDT positive test were admitted to the cohorted COVD-19 department of the hospital. By using Ag-RDT, 35.9% of rapid PCR tests (that are more costly and laborious to perform) could be avoided at cost of 5.8% patients with false positive result. In conclusion, in real practice, disease prevalence is as important as test's performance for clinical decision making. The conclusion may also be applicable for other diagnostic tests than COVID-19 diagnostic. |
| first_indexed | 2024-12-10T18:18:34Z |
| format | Article |
| id | doaj.art-bc932f3353634fc794d0a3c396d5f465 |
| institution | Directory Open Access Journal |
| issn | 1413-8670 |
| language | English |
| last_indexed | 2024-12-10T18:18:34Z |
| publishDate | 2022-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brazilian Journal of Infectious Diseases |
| spelling | doaj.art-bc932f3353634fc794d0a3c396d5f4652022-12-22T01:38:16ZengElsevierBrazilian Journal of Infectious Diseases1413-86702022-07-01264102389The importance of disease prevalence in clinical decision making: a real practice study on COVID-19 antigen test in CuracaoErlangga Yusuf0Liane Virginia-Cova1Lisette B Provacia2Jeanne Koeijers3Vanessa Brown4Curacao Medical Center, Willemstad, Curacao; Analytisch Diagnostisch Centrum NV, Willemstad, Curacao; Erasmus University Medical Center, Rotterdam, the Netherlands; Corresponding author at: Erasmus University Medical Center, Rotterdam, the Netherlands.Analytisch Diagnostisch Centrum NV, Willemstad, CuracaoAnalytisch Diagnostisch Centrum NV, Willemstad, CuracaoCuracao Medical Center, Willemstad, CuracaoCuracao Medical Center, Willemstad, CuracaoThe performance of a test can be suboptimal, but in appropriate setting such a test is still useful for clinical decision making. We investigated the role of Antigen Rapid Diagnostic Test (Ag-RDT) for clinical decision making in an Emergency Department (ED) in Curacao during peak of COVID-19 pandemic. Ag-RDT was performed in the naso- and oropharynx-swabs from patients with respiratory insufficiency presented to the ED. Ag-RDT was performed in 153 patients, of which 64 (41.8%) showed positive results. Comparing Ag-RDT results with molecular tests, its sensitivity was 68.8% (95% CI 57.4 to 78.7), and specificity of 94.6% (95% CI 84.9 to 98.9). The positive and negative predictive value were 95.1% (95% CI 86.5 to 98.3) and 66.3 (95% CI 58.6 to 73.3), respectively. All patients with Ag-RDT positive test were admitted to the cohorted COVD-19 department of the hospital. By using Ag-RDT, 35.9% of rapid PCR tests (that are more costly and laborious to perform) could be avoided at cost of 5.8% patients with false positive result. In conclusion, in real practice, disease prevalence is as important as test's performance for clinical decision making. The conclusion may also be applicable for other diagnostic tests than COVID-19 diagnostic.http://www.sciencedirect.com/science/article/pii/S1413867022000769COVID-19Rapid antigen testPerformanceSensitivityPositive predictive value |
| spellingShingle | Erlangga Yusuf Liane Virginia-Cova Lisette B Provacia Jeanne Koeijers Vanessa Brown The importance of disease prevalence in clinical decision making: a real practice study on COVID-19 antigen test in Curacao Brazilian Journal of Infectious Diseases COVID-19 Rapid antigen test Performance Sensitivity Positive predictive value |
| title | The importance of disease prevalence in clinical decision making: a real practice study on COVID-19 antigen test in Curacao |
| title_full | The importance of disease prevalence in clinical decision making: a real practice study on COVID-19 antigen test in Curacao |
| title_fullStr | The importance of disease prevalence in clinical decision making: a real practice study on COVID-19 antigen test in Curacao |
| title_full_unstemmed | The importance of disease prevalence in clinical decision making: a real practice study on COVID-19 antigen test in Curacao |
| title_short | The importance of disease prevalence in clinical decision making: a real practice study on COVID-19 antigen test in Curacao |
| title_sort | importance of disease prevalence in clinical decision making a real practice study on covid 19 antigen test in curacao |
| topic | COVID-19 Rapid antigen test Performance Sensitivity Positive predictive value |
| url | http://www.sciencedirect.com/science/article/pii/S1413867022000769 |
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