Evidence map›Paper›PMID 34555117›Full record

ArticlePloS one2021

An optimized stepwise algorithm combining rapid antigen and RT-qPCR for screening of COVID-19 patients.

Philippe Halfon, Guillaume Penaranda, Hacène Khiri, Vincent Garcia, Hortense Drouet, Patrick Philibert, Christina Psomas, Marion Delord, Frédérique Retornaz, Caroline Charpin and 3 more

Abstract read
In one paragraph

Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 4 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

5 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Rapid, point-of-care antigen tests for diagnosis of SARS-CoV-2 infection.The Cochrane database of systematic reviews · 2025
    Pooled it
  2. Rapid, point-of-care antigen tests for diagnosis of SARS-CoV-2 infection.The Cochrane database of systematic reviews · 2022
    Pooled it
  3. Pooled it
  4. Pooled it
  5. Article
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

13 authors.

Philippe HalfonLaboratoire Alphabio, Marseille, France.
Guillaume PenarandaLaboratoire Alphabio, Marseille, France.ORCID 0000-0002-7461-4254
Hacène KhiriLaboratoire Alphabio, Marseille, France.
Vincent GarciaLaboratoire Alphabio, Marseille, France.
Hortense DrouetService de Médecine Interne et de Maladies Infectieuses, Hôpital Européen Marseille, Marseille, France.
Patrick PhilibertService de Médecine Interne et de Maladies Infectieuses, Hôpital Européen Marseille, Marseille, France.
Christina PsomasService de Médecine Interne et de Maladies Infectieuses, Hôpital Européen Marseille, Marseille, France.
Marion DelordService de Médecine Interne et de Maladies Infectieuses, Hôpital Européen Marseille, Marseille, France.
Frédérique RetornazService de Médecine Interne et de Maladies Infectieuses, Hôpital Européen Marseille, Marseille, France.
Caroline CharpinService de Médecine Interne et de Maladies Infectieuses, Hôpital Européen Marseille, Marseille, France.
Thomas GonzalesService de Médecine Interne et de Maladies Infectieuses, Hôpital Européen Marseille, Marseille, France.
Hervé PegliascoService de Pneumologie, Hôpital Européen, Marseille, France.
Jérôme Allardet-ServentService de Réanimation, Hôpital Européen, Marseille, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND &

aimWe investigated the combination of rapid antigen detection (RAD) and RT-qPCR assays in a stepwise procedure to optimize the detection of COVID-19.

methodsFrom August 2020 to November 2020, 43,399 patients were screened in our laboratory for COVID-19 diagnostic by RT-qPCR using nasopharyngeal swab. Overall, 4,691 of the 43,399 were found to be positive, and 200 were retrieved for RAD testing allowing comparison of diagnostic accuracy between RAD and RT-qPCR. Cycle threshold (Ct) and time from symptoms onset (TSO) were included as covariates.

resultsThe overall sensitivity, specificity, PPV, NPV, LR-, and LR+ of RAD compared with RT-qPCR were 72% (95%CI 62%-81%), 99% (95% CI95%-100%), 99% (95%CI 93%-100%), and 78% (95%CI 70%-85%), 0.28 (95%CI 0.21-0.39), and 72 (95%CI 10-208) respectively. Sensitivity was higher for patients with Ct ≤ 25 regardless of TSO: TSO ≤ 4 days 92% (95%CI 75%-99%), TSO > 4 days 100% (95%CI 54%-100%), and asymptomatic 100% (95%CI 78-100%). Overall, combining RAD and RT-qPCR would allow reducing from only 4% the number of RT-qPCR needed.

conclusionsThis study highlights the risk of misdiagnosing COVID-19 in 28% of patients if RAD is used alone. A stepwise analysis that combines RAD and RT-qPCR would be an efficient screening procedure for COVID-19 detection and may facilitate the control of the outbreak.

Indexed as

AlgorithmsAntigens, ViralCOVID-19COVID-19 Nucleic Acid TestingFemaleHumansMaleMass ScreeningMiddle AgedReal-Time Polymerase Chain ReactionSARS-CoV-2Sensitivity and SpecificityAntigens, Viral

Identifiers

PMID34555117
PMCPMC8460002

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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.