Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
Department of Nursing, Cardinal Tien Junior College of Healthcare and Management, Yilan, Taiwan.
Medicine (Baltimore). 2023 Aug 18;102(33):e34927. doi: 10.1097/MD.0000000000034927.
Point-of-care tests for coronavirus disease 2019 (COVID-19) antigen detection have been widely used for rapid diagnosis in various settings. However, research on the diagnostic performance of the COVID-19 antigen test performed by non-laboratory personnel is limited. In this study, we aimed to elucidate the diagnostic performance of GenBody COVID-19 rapid antigen between laboratory professionals and non-laboratory staff. We retrospectively analyzed the data of patients who underwent both GenBody COVID-19 rapid antigen testing and reverse transcription polymerase chain reaction (RT-PCR) between November 01, 2021, and June 30, 2022. The diagnostic performance of the antigen test was compared between laboratory and non-laboratory operators, using RT-PCR as the gold standard. Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, positive predictive value, negative predictive value, and accuracy were calculated and sensitivity analysis was performed based on the PCR cycle threshold (Ct) value. Of the 11,963 patients, 1273 (10.6%) tested positive using real-time RT-PCR. The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, positive predictive value, negative predictive value, and accuracy of the GenBody COVID-19 rapid antigen test with 95% confidence interval were 79.92% (77.26%-82.39%), 99.23% (98.73%-99.57%), 103.25 (62.31-171.11), 0.2 (0.18-0.23), 510.18 (299.81-868.18), 98.11% (96.91%-98.85%), 90.75% (89.64%-91.75%) and 92.76% (91.76%-93.67%), respectively, for non-laboratory staff and 79.80% (74.78%-84.22%), 99.99% (99.94%-100.00%), 6983.92 (983.03-49617.00), 0.2 (0.16-0.25), 34566.45 (4770.30-250474.46) 99.58% (97.09%-99.94%), 99.32% (99.15%-99.46%), and 99.33% (99.13%-99.48%), respectively, for laboratory staff. Notably, when the PCR Ct value exceeded 25, the sensitivity of both the groups decreased to < 40%. The diagnostic performance of GenBody COVID-19 rapid antigen performed by non-laboratory staff was comparable to that of laboratory professionals. However, it should be noted that the sensitivity of the antigen tests decreased when the PCR Ct value exceeded 25. Overall, the GenBody COVID-19 antigen test is a viable option for non-laboratory staff during an epidemic.
用于检测 2019 年冠状病毒病(COVID-19)抗原的即时检测已广泛用于各种环境中的快速诊断。然而,关于非实验室人员进行的 COVID-19 抗原检测的诊断性能的研究是有限的。在这项研究中,我们旨在阐明实验室专业人员和非实验室人员之间的 GenBody COVID-19 快速抗原的诊断性能。我们回顾性分析了 2021 年 11 月 1 日至 2022 年 6 月 30 日期间同时接受 GenBody COVID-19 快速抗原检测和逆转录聚合酶链反应(RT-PCR)的患者的数据。以 RT-PCR 为金标准,比较了抗原检测在实验室和非实验室操作人员之间的诊断性能。计算了敏感性、特异性、阳性似然比、阴性似然比、诊断比值比、阳性预测值、阴性预测值和准确度,并根据 PCR 循环阈值(Ct)值进行了敏感性分析。在 11963 名患者中,1273 名(10.6%)经实时 RT-PCR 检测呈阳性。GenBody COVID-19 快速抗原检测的敏感性、特异性、阳性似然比、阴性似然比、诊断比值比、阳性预测值、阴性预测值和准确度的 95%置信区间分别为 79.92%(77.26%-82.39%)、99.23%(98.73%-99.57%)、103.25(62.31-171.11)、0.2(0.18-0.23)、510.18(299.81-868.18)、98.11%(96.91%-98.85%)、90.75%(89.64%-91.75%)和 92.76%(91.76%-93.67%),非实验室人员的特异性为 99.23%(98.73%-99.57%),实验室人员的敏感性为 79.80%(74.78%-84.22%)、特异性为 99.99%(99.94%-100.00%)、阳性似然比为 6983.92(983.03-49617.00)、阴性似然比为 0.2(0.16-0.25)、诊断比值比为 34566.45(4770.30-250474.46)、阳性预测值为 99.58%(97.09%-99.94%)、阴性预测值为 99.32%(99.15%-99.46%)和准确度为 99.33%(99.13%-99.48%)。值得注意的是,当 PCR Ct 值超过 25 时,两组的敏感性均降至<40%。非实验室人员进行的 GenBody COVID-19 快速抗原检测的诊断性能与实验室专业人员相当。然而,应该注意的是,当 PCR Ct 值超过 25 时,抗原检测的敏感性会下降。总的来说,GenBody COVID-19 抗原检测是疫情期间非实验室人员的可行选择。