Evidence map›Paper›PMID 29703707›Full record

SynthesisThe lancet. HIV2018

Reliability of HIV rapid diagnostic tests for self-testing compared with testing by health-care workers: a systematic review and meta-analysis.

Carmen Figueroa, Cheryl Johnson, Nathan Ford, Anita Sands, Shona Dalal, Robyn Meurant, Irena Prat, Karin Hatzold, Willy Urassa, Rachel Baggaley

Abstract readComparative StudyMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The lancet. HIV, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 140 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
140citing papers in PubMed, 10 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

140 citing papers in PubMed, 10 syntheses or guidelines pooled it.

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  7. A Systematic Review and Network Meta-analyses to Assess the Effectiveness of Human Immunodeficiency Virus (HIV) Self-testing Distribution Strategies.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021
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80 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Carmen FigueroaDepartment of HIV, World Health Organization, Geneva, Switzerland. Electronic address: karrleen@hotmail.com.
Cheryl JohnsonDepartment of HIV, World Health Organization, Geneva, Switzerland; Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK.
Nathan FordDepartment of HIV, World Health Organization, Geneva, Switzerland.
Anita SandsDepartment of Essential Medicines and Health Products, World Health Organization, Geneva, Switzerland.
Shona DalalDepartment of HIV, World Health Organization, Geneva, Switzerland.
Robyn MeurantDepartment of Essential Medicines and Health Products, World Health Organization, Geneva, Switzerland.
Irena PratDepartment of Essential Medicines and Health Products, World Health Organization, Geneva, Switzerland.
Karin HatzoldPSI Zimbabwe, Harare, Zimbabwe.
Willy UrassaDepartment of Essential Medicines and Health Products, World Health Organization, Geneva, Switzerland.
Rachel BaggaleyDepartment of HIV, World Health Organization, Geneva, Switzerland.

Funding

World Health Organization 001
6 · The paper itself

Abstract

backgroundThe ability of individuals to use HIV self-tests correctly is debated. To inform the 2016 WHO recommendation on HIV self-testing, we assessed the reliability and performance of HIV rapid diagnostic tests when used by self-testers.

methodsIn this systematic review and meta-analysis, we searched PubMed, PopLine, and Embase, conference abstracts, and additional grey literature between Jan 1, 1995, and April 30, 2016, for observational and experimental studies reporting on HIV self-testing performance. We excluded studies evaluating home specimen collection because patients did not interpret their own test results. We extracted data independently, using standardised extraction forms. Outcomes of interest were agreement between self-testers and health-care workers, sensitivity, and specificity. We calculated κ to establish the level of agreement and pooled κ estimates using a random-effects model, by approach (directly assisted or unassisted) and type of specimen (blood or oral fluid). We examined heterogeneity with the I

findings25 studies met inclusion criteria (22 to 5662 participants). Quality assessment with QUADAS-2 showed studies had low risk of bias and incomplete reporting in accordance with the STARD checklist. Raw proportion of agreement ranged from 85·4% to 100%, and reported κ ranged from fair (κ 0·277, p<0·001) to almost perfect (κ 0·99, n=25). Pooled κ suggested almost perfect agreement for both types of approaches (directly assisted 0·98, 95% CI 0·96-0·99 and unassisted 0·97, 0·96-0·98; I

interpretationSelf-testers can reliably and accurately do HIV rapid diagnostic tests, as compared with trained health-care workers. Errors in performance might be reduced through the improvement of rapid diagnostic tests for self-testing, particularly to make sample collection easier and to simplify instructions for use.

fundingThe Bill & Melinda Gates Foundation and Unitaid.

Indexed as

Diagnostic Tests, RoutinePoint-of-Care TestingSerologic TestsHIV InfectionsHumansReproducibility of ResultsSelf CareSensitivity and Specificity

Identifiers

PMID29703707
PMCPMC5986793

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.