ArticleEmergency medicine journal : EMJ2014
Is the interpretation of rapid antigen testing for respiratory syncytial virus as simple as positive or negative?
Article in Emergency medicine journal : EMJ, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Diagnostic Accuracy of Rapid Antigen Detection Tests for Respiratory Syncytial Virus Infection: Systematic Review and Meta-analysis.Journal of clinical microbiology · 2015Pooled it
- ERS/ESCMID state-of-the-science statement on the role of rapid diagnostic tests for the diagnosis and management of community-acquired lower respiratory tract infections.The European respiratory journal · 2026Review
- Delineating RSV-A and RSV-B: Epidemiological Patterns, Diagnostics, Clinical Severity, and Preventive Approaches.Journal of medical virology · 2026Review
- Respiratory Syncytial Virus: Infection, Detection, and New Options for Prevention and Treatment.Clinical microbiology reviews · 2017Review
- Derivation of Candidate Clinical Decision Rules to Identify Infants at Risk for Central Apnea.Pediatrics · 2015Observational
- The Underrecognized Burden of Respiratory Syncytial Virus Among Infants Presenting to US Emergency Departments.Clinical pediatrics · 2015Article
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12 authors.
Funding
Abstract
objectiveTo measure the performance characteristics of an immunochromatographic rapid antigen test for respiratory syncytial virus (RSV) and determine how its interpretation should be contextualised in patients presenting to the emergency department (ED) with bronchiolitis.
designDiagnostic accuracy study of a rapid RSV test.
settingCounty hospital ED.
interventionWe took paired nasal samples from consecutively enrolled infants with bronchiolitis and tested them with a rapid immunochromatographic antigen test and reverse transcriptase PCR gold standard. OUTCOME MEASURES: Sensitivity, specificity, the effect of point prevalence, clinical findings and overall context on predictive values. We used these to construct a graphical contextual model to show how the results of RSV antigen tests from infants presenting within 24 h should influence interpretation of subsequent antigen tests.
resultsWe analysed 607 patients. The sensitivity and specificity for immunochromatographic testing was 79.4% (95% CI 73.9% to 84.2%) and 67.1% (95% CI 61.9% to 72%) respectively. We found little evidence of spectrum bias. In our contextual model the best predictor of a positive RT-PCR test was a positive antigen test OR 5.47 (95% CI 3.65 to 8.18) and the number of other infants having positive tests within 24 h OR 1.48 (95% CI 1.26 to 1.72) per infant. Increasing numbers presenting to the ED with bronchiolitis in a given day increases the probability of RSV infection.
conclusionsThe RSV antigen test we examined had modest performance characteristics. The results of the antigen test should be interpreted in the context of the results of previous tests.
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