Utility of SARS-CoV-2 rapid antigen testing for patient triage in the emergency department: A clinical implementation study in Melbourne, Australia

COVID-19 rapid antigen testing strategies must be evaluated in intended use settings

“…The lack of observed false-positive results (specificity 100% 6 ) in a large study such as this is surprising given that we know that RAT tests do have a very small risk of misclassification of disease negative individuals (average specificity 99.6% 3 ). When infection rates are high or RATs are used in those at higher risk of infection, the potential harm from false positive results is likely outweighed by earlier detection of true cases.…”

“…In The Lancet Regional Health − Western Pacific , Bond and colleagues report a large field-based validation study assessing the accuracy and impact of the Abbott Panbio™ RAT in a hospital emergency department setting during a period of relatively high community transmission of SARS-CoV-2. 6 A standardised triage system for emergency admissions based on prior COVID-19 test results, the presence of signs and symptoms of COVID-19 or of likely epidemiological exposure to infection was already established at the hospital, with safety measures such as patient isolation and level of staff PPE guided by RT-PCR results on admission. The observed sensitivity of the RAT in this setting was 75.5% overall.…”

“…Bond and colleagues 6 have demonstrated that RAT testing may be a useful strategy when used in combination with COVID-19 symptom and epidemiological profiles, particularly during a period of rising infection rates and when implemented as triage to RT-PCR. Notably, the study also highlights the importance of validating tests in the specific context in which they will be used and of evaluation of the potential impact from tests beyond test accuracy alone.…”

Impact of a national-scale targeted point-of-care symptomatic Lateral Flow Testing on trends in COVID-19 infections, hospitalisations and deaths during the second epidemic wave in Austria (REAP3)

“…LFTs have been shown to be a reliable and accurate tool for the detection of infectious individuals 19 and when used for clinical triage in emergency department settings 20 and primary care 1 . Targeted symptomatic POC-LFT in outpatient settings combined with early TTI is likely to be superior to PCR in curbing transmission.…”

COVID-19 and isolation: Risks and implications in the scenario of new variants

“…Its advantages include low cost, fast release time (around 20 minutes), and specificity close to 100%. [ 61 , 62 ] However, its main disadvantage compared to RT-PCR testing is a lower diagnostic sensitivity, due to limitations in the methodology.…”