Center for Mind/Brain Sciences, University of Trento, Rovereto (TN), Italy.
Center for Mind/Brain Sciences, University of Trento, Rovereto (TN), Italy
BMJ Open. 2021 Jan 17;11(1):e043925. doi: 10.1136/bmjopen-2020-043925.
Although widespread testing for SARS-CoV-2 is in place, little is known about how well the public understands these results. We aimed to provide a comprehensive overview of the general public's grasp of the accuracy and significance of the results of the swab test.
Web-based behavioural experiment.
Italy during the April 2020 lockdown.
566 Italian residents.
Participants' estimates of the SARS-CoV-2 prevalence; the predictive and diagnostic accuracy of the test; the behavioural impact of (positive vs negative) test results; the perceived usefulness of a short-term repetition of the test following positive or negative results; and rankings of causes for false positives and false negatives.
Most participants considered the swab test useful (89.6%) and provided predictive values consistent with their estimates of test diagnostic accuracy and infection prevalence (67.0%). Participants acknowledged the effects of symptomatic status and geographical location on prevalence (all p<0.001) but failed to take this information into account when estimating the positive or negative predictive value. Overall, test specificity was underestimated (91.5%, 95% CI 90.2% to 92.8%); test sensitivity was overestimated (89.7%, 95% CI 88.3% to 91.0%). Positive results were evaluated as more informative than negative ones (91.6, 95% CI 90.2 to 93.1 and 41.0, 95% CI 37.9 to 44.0, respectively, p<0.001); a short-term repetition of the test was considered more useful after a positive than a negative result (62.7, 95% CI 59.6 to 65.7 and 47.2, 95% CI 44.4 to 50.0, respectively, p=0.013). Human error and technical characteristics were assessed as more likely to be the causes of false positives (p<0.001); the level of the viral load as the cause of false negatives (p<0.001).
While some aspects of the swab for SARS-CoV-2 are well grasped, others are not and may have a strong bearing on the general public's health and well-being. The obtained findings provide policymakers with a detailed picture that can guide the design and implementation of interventions for improving efficient communication with the general public as well as adherence to precautionary behaviour.
尽管已经广泛开展 SARS-CoV-2 检测，但公众对检测结果的理解程度仍知之甚少。本研究旨在全面了解公众对咽拭子检测结果准确性和重要性的理解。
基于网络的行为实验。
意大利 2020 年 4 月封锁期间。
566 名意大利居民。
参与者对 SARS-CoV-2 流行率的估计；检测的预测和诊断准确性；（阳性与阴性）检测结果的行为影响；对阳性或阴性结果后短期重复检测的感知有用性；以及假阳性和假阴性的原因排名。
大多数参与者认为咽拭子检测有用（89.6%），并提供了与他们对检测诊断准确性和感染流行率的估计一致的预测值（67.0%）。参与者承认症状状态和地理位置对流行率的影响（均 p<0.001），但在估计阳性或阴性预测值时并未考虑这些信息。总体而言，检测特异性被低估（91.5%，95%CI 90.2%至 92.8%）；检测敏感性被高估（89.7%，95%CI 88.3%至 91.0%）。阳性结果比阴性结果被评估为更具信息量（91.6，95%CI 90.2 至 93.1 和 41.0，95%CI 37.9 至 44.0，分别，p<0.001）；与阴性结果相比，阳性结果后短期重复检测被认为更有用（62.7，95%CI 59.6 至 65.7 和 47.2，95%CI 44.4 至 50.0，分别，p=0.013）。人为错误和技术特征被评估为更可能是假阳性的原因（p<0.001）；病毒载量水平是假阴性的原因（p<0.001）。
虽然咽拭子检测的某些方面得到了很好的理解，但其他方面仍未得到理解，这可能对公众的健康和福祉产生重大影响。研究结果为政策制定者提供了详细的信息，可用于指导干预措施的设计和实施，以改善与公众的有效沟通以及预防行为的依从性。
