Rapid molecular tests for influenza, respiratory syncytial virus, and other respiratory viruses: a systematic review of diagnostic accuracy and clinical impact studies.
Clin Infect Dis. 2019 Jan 28;:
Authors: Vos LM, Bruning AHL, Reitsma JB, Schuurman R, Riezebos-Brilman A, Hoepelman AIM, Oosterheert JJ
Abstract
We systematically reviewed available evidence from EMBASE, MEDLINE and the Cochrane Library on diagnostic accuracy and clinical impact of commercially available rapid (results <3 hours) molecular diagnostics for respiratory viruses as compared to conventional molecular tests. Quality of included studies was assessed using the QUADAS-2 criteria for diagnostic test accuracy (DTA) studies, and the Cochrane Risk of Bias Assessment and ROBINS-I criteria for randomized and observational impact studies, respectively. 63 DTA reports (56 studies) were meta-analysed with a pooled sensitivity of 90.9% (95% confidence interval (CI), 88.7%-93.1%) and specificity of 96.1% (95%CI, 94.2%-97.9%) for the detection of either influenza virus (n=29), RSV (n=1), influenza virus and RSV (n=19), or a viral panel including influenza virus and RSV (n=14). The 15 included impact studies - 5 randomized - were very heterogeneous and results were therefore inconclusive. We however suggest to consider implementation of rapid diagnostics in hospital care settings.
Prospero registration: CRD42017057881.
PMID: 30689772 [PubMed - as supplied by publisher]