Comparable performance of antigen‐detecting rapid test by healthcare worker‐collected and self‐collected swabs for SARS‐CoV‐2 diagnostic: A systematic review and meta‐analysis

Abstract

AbstractUsage of self‐screening tests has become increasingly relevant in public health perspective for early detection of SARS‐CoV‐2 infection in the transitioning era of the COVID‐19 pandemic into an endemic. This study was designed to compare the diagnostic accuracy of self‐conducted and health professional‐conducted SARS‐CoV‐2 rapid antigen tests (Ag‐RDTs) and whether the sample was taken from anterior nasal or nasal mid‐turbinate. Eligible comparative Ag‐RDTs accuracy studies were retrieved from electronic databases systematically, in accordance with PRISMA. Selected studies were assessed for risk of bias using QUADAS‐2 and QUADAS‐C. In total, we selected five out of 1952 studies retrieved using the keywords. The overall sensitivity for the self‐collected nasal swab method and healthcare worker‐collected nasopharyngeal swab method was 79% (95% CI 68–87; I2 = 62%) and 83% (95% CI 75–89; I2 = 32%), respectively, which was not statistically different (p = 0.499). Nasal mid‐turbinate swabs have a significantly higher sensitivity compared to anterior nasal swabs (p < 0.01). Both sampling methods represent high and comparable specificity values of 98% (95% CI 97–99; I2 = 0%) and 99% (95% CI 98–99; I2 = 0%). Positive predictive value (range 90%–99%) and negative predictive value (range 87%–98%) were equivalent for both methods. Our findings indicated the accuracy of self‐collected Ag‐RDT on nasal swabs was comparable to those performed by healthcare worker‐collected on nasopharyngeal swabs. Self‐collected Ag‐RDT could be considered as a transmission prevention method in the transition of COVID‐19 pandemic.