Performance of rapid influenza H1N1 diagnostic tests: A meta-analysis

Haitao Chu, Eric T. Lofgren, M. Elizabeth Halloran, Pei F. Kuan, Michael Hudgens, Stephen R. Cole

Research output: Contribution to journalReview article

20 Scopus citations

Abstract

Background Following the outbreaks of 2009 pandemic H1N1 infection, rapid influenza diagnostic tests have been used to detect H1N1 infection. However, no meta-analysis has been undertaken to assess the diagnostic accuracy when this manuscript was drafted. Methods The literature was systematically searched to identify studies that reported the performance of rapid tests. Random effects meta-analyses were conducted to summarize the overall performance. Results Seventeen studies were selected with 1879 cases and 3477 non-cases. The overall sensitivity and specificity estimates of the rapid tests were 0·51 (95%CI: 0·41, 0·60) and 0·98 (95%CI: 0·94, 0·99). Studies reported heterogeneous sensitivity estimates, ranging from 0·11 to 0·88. If the prevalence was 30%, the overall positive and negative predictive values were 0·94 (95%CI: 0·85, 0·98) and 0·82 (95%CI: 0·79, 0·85). The overall specificities from different manufacturers were comparable, while there were some differences for the overall sensitivity estimates. BinaxNOW had a lower overall sensitivity of 0·39 (95%CI: 0·24, 0·57) compared with all the others (P-value <0·001), whereas QuickVue had a higher overall sensitivity of 0·57 (95%CI: 0·50, 0·63) compared with all the others (P-value=0·005). Conclusions Rapid tests have high specificity but low sensitivity and thus limited usefulness.

Original languageEnglish (US)
Pages (from-to)80-86
Number of pages7
JournalInfluenza and other Respiratory Viruses
Volume6
Issue number2
DOIs
StatePublished - Mar 2012

Keywords

  • Diagnostic tests
  • H1N1
  • Meta-analysis
  • Rapid tests
  • Sensitivity and specificity

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