COVID-19 Testing Impact of Prevalence, Sensitivity, and Specificity on Patient Risk and Cost
COVID-19 Testing Impact of Prevalence, Sensitivity, and Specificity on Patient Risk and Cost
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DOI：
10.1093/ajcp/aqaa141
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发表时间：
2020-11-01
影响因子：
3.5
通讯作者：
Das, Saswati
中科院分区：
文献类型：
--
作者：
Brooks, Zoe C.;Das, Saswati
目的：为了说明假阳性和假阴性结果如何驱动患者风险和临床成本，分子，抗原和抗体检测是识别感染患者和对抗严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的主要手段。为了评价检测方法，灵敏度（阳性一致率[PPA]）和特异性（阴性一致率[PPA]）是最常用的指标，其次是阳性和阴性预测值-阳性或阴性检测结果代表真阳性或阴性患者的概率。虚假结果的数量，概率和成本是由流行率，PPA和PNA的组合选择的个别测试由laborator.Results：分子和抗原检测，检测病毒的存在是相关的急性期只有血清学检测SARS-CoV-2的抗体在恢复和恢复阶段。每个测试方法都有其优点和缺点。结论：我们证明了报告假阳性结果的概率，假阴性结果的概率，以及对患者和医疗保健的成本的价值。这些风险指标可以从PPA和PNA的风险驱动因素中计算出来，并结合患病率、成本和参考人数（感染1例阳性SA RS-CoV-2携带者的人数）的估计值。(C)美国临床病理学会，2020年。All rights reserved.
Objectives: To illustrate how patient risk and clinical costs are driven by false-positive and false-negative results.Methods: Molecular, antigen, and antibody testing are the mainstay to identify infected patients and fight the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). To evaluate the test methods, sensitivity (percent positive agreement [PPA]) and specificity (percent negative agreement [PPA]) are the most common metrics utilized, followed by the positive and negative predictive value-the probability that a positive or negative test result represents a true positive or negative patient. The number, probability, and cost of false results are driven by combinations of prevalence, PPA, and PNA of the individual test selected by the laboratory.Results: Molecular and antigen tests that detect the presence of the virus are relevant in the acute phase only Serologic assays detect antibodies to SARS-CoV-2 in the recovering and recovered phase. Each testing methodology has its advantages and disadvantages.Conclusions: We demonstrate the value of reporting probability of false-positive results, probability of false-negative results, and costs to patients and health care. These risk metrics can be calculated from the risk drivers of PPA and PNA combined with estimates of prevalence, cost, and Reff number (people infected by 1 positive SA RS-CoV-2 carrier). (C) American Society for Clinical Pathology, 2020. All rights reserved.