Evidence map›Paper›PMID 32366227›Full record

ArticleBMC infectious diseases2020

Continuous quality monitoring in the field: an evaluation of the performance of the Fio Deki Reader™ for rapid HIV testing in South Africa.

Lara Noble, Lesley Scott, Lynsey Stewart-Isherwood, Seponono John Molifi, Ian Sanne, Pedro Da Silva, Wendy Stevens

Abstract readEvaluation Study
In one paragraph

Article in BMC infectious diseases, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–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

4 citing papers in PubMed.

  1. Nucleic Acid Point-of-Care Testing to Improve Diagnostic Preparedness.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022
    Article
  2. Review
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Lara NobleDepartment of Molecular Medicine and Haematology, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa. lara.noble@wits.ac.za.ORCID http://orcid.org/0000-0002-4661-9023
Lesley ScottDepartment of Molecular Medicine and Haematology, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa.
Lynsey Stewart-IsherwoodDepartment of Molecular Medicine and Haematology, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa.
Seponono John MolifiNational Priority Programme, National Health Laboratory Service, Johannesburg, Gauteng, South Africa.
Ian SanneRight to Care, Johannesburg, Gauteng, South Africa.
Pedro Da SilvaNational Priority Programme, National Health Laboratory Service, Johannesburg, Gauteng, South Africa.
Wendy StevensDepartment of Molecular Medicine and Haematology, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa.

Funding

Bill and Melinda Gates Foundation OPP1171455Global Fund to Fight AIDS, Tuberculosis and Malaria (CH) ZAC-C-NDOHMedical Research Council MC_PC_16021South African Medical Research Council #015NEWTON TB
6 · The paper itself

Abstract

backgroundRapid diagnostic tests (RDTs) are a cornerstone of HIV diagnosis and rely on good quality processing and interpretation, particularly in the era of test and treat. The Deki Reader (Fio Corporation®, Toronto, Ontario, Canada) is a portable device designed specifically for analysing RDTs and was selected for evaluation in South Africa in the context of HIV RDT analysis.

methodsThis study consisted of a laboratory evaluation and two-part field evaluation of the Deki Reader v100, covering two RDT testing algorithms, and an evaluation of the continuous quality monitoring through the Fionet™ web portal. Based on user feedback from the field evaluation, the device underwent hardware and software redesign, and the Deki Reader v200 was evaluated in the laboratory. Ethics approval for this evaluation was obtained from the University of the Witwatersrand Human Research Ethics Committee: M150160.

resultsThe intra- and inter-device laboratory precision of the Deki Reader v100 were 98.3 and 99.2% respectively, and 99.3 and 100% for the Deki Reader v200. The laboratory concordances compared to standard-of-care reporting were 99.5 and 98.0% for the two respective models, while sensitivity and specificity were 99.5 and 99.4% for the Deki Reader V100 and 100 and 93.1% for the Deki Reader V200 respectively. Screening and confirmatory concordances in the field were 99.3 and 96.5% under algorithm 1 and 99.7 and 100% under algorithm 2. Sensitivity and specificity for the field evaluation were 99.8 and 97.7%. Overall robustness of the device was acceptable and continuous quality monitoring through Fionet™ was feasible.

conclusionsThe Deki Reader provides an option for improved and reliable quality assessment for rapid diagnosis of HIV using RDTs to enhance the quality of healthcare at the point-of-care. However, the introduction of new RDTs and modification of current algorithms necessitates ongoing and agile RDT reader adjustments, which will require cost modelling to ensure sustainability of devices implemented into national HIV programs.

Indexed as

AIDS SerodiagnosisAlgorithmsDiagnostic Tests, RoutineEnzyme-Linked Immunosorbent AssayHIV-1HIV-2HIV InfectionsHumansMass ScreeningMobile ApplicationsPoint-of-Care SystemsPrevalenceSensitivity and SpecificitySouth AfricaAutomated rapid strip readerContinuous quality monitoringDeki readerHIVRapid diagnostic test

Identifiers

PMID32366227
PMCPMC7199324

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Registered trials

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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.