Test, test, test for COVID-19 antibodies: the importance of sensitivity, specificity and predictive powers
Test, test, test for COVID-19 antibodies: the importance of sensitivity, specificity and predictive powers
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DOI：
10.1016/j.puhe.2020.06.006
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发表时间：
2020-08-01
期刊：
影响因子：
5.2
通讯作者：
Stigler, F. L.
中科院分区：
文献类型：
--
作者：
Kumleben, N.;Bhopal, R.;Stigler, F. L.
目前可提供不同特异性和敏感性的严重急性呼吸综合征冠状病毒2 （SARS-CoV-2）抗体检测。为了告知人们他们是否患有2019冠状病毒病（COVID-19），他们需要非常准确。为了测量过去感染的人口流行率，假阳性和阴性的数量需要大致相等。通过对100,000人的假设人群的一系列工作示例，我们表明，即使具有高特异性的测试系统也会产生大量假阳性结果，特别是在人群患病率较低的情况下。例如，在真实人群患病率为5%的情况下，使用具有99%敏感性和特异性的测试，16%的阳性结果将是假的，因此950人将被错误地告知他们已经感染。可能需要进一步的确认测试。提供虚假的保证，作为个人或社会决定的可能依据，可能对个人有害，破坏公众信心，并引发进一步的疫情。(C) 2020英国皇家公共卫生学会。Elsevier Ltd.出版。版权所有。
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody tests of varying specificity and sensitivity are now available. For informing individuals whether they have had coronavirus disease 2019 (COVID-19), they need to be very accurate. For measuring population prevalence of past infection, the numbers of false positives and negatives need to be roughly equal.With a series of worked examples for a notional population of 100,000 people, we show that even test systems with a high specificity can yield a large number of false positive results, especially where the population prevalence is low. For example, at a true population prevalence of 5%, using a test with 99% sensitivity and specificity, 16% of positive results will be false and thus 950 people will be incorrectly informed they have had the infection. Further confirmatory testing may be needed.Giving false reassurance on which personal or societal decisions might be based could be harmful for individuals, undermine public confidence and foster further outbreaks. (C) 2020 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.