Evidence map›Paper›PMID 38856828›Full record

SynthesisEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2024

Self-swabbing versus assisted swabbing for viral detection by qRT-PCR: the experience from SARS-CoV-2 based on a meta-analysis of six prospectively designed evaluations conducted in a UK setting.

Tom Fowler, David Chapman, Matthias E Futschik, Sarah A Tunkel, Edward Blandford, Elena Turek, Olumide Kolade, Sergio Souza da Cunha, Andrew Dodgson, Paul Klapper and 5 more

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

Synthesis in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 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

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. 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

15 authors.

Tom FowlerUK Health Security Agency, 10 South Colonnade, Canary Wharf, London, E14 4PU, UK. tom.fowler2@ukhsa.gov.uk.
David ChapmanDeloitte MCS Ltd, London, UK.
Matthias E FutschikUK Health Security Agency, 10 South Colonnade, Canary Wharf, London, E14 4PU, UK.
Sarah A TunkelUK Health Security Agency, 10 South Colonnade, Canary Wharf, London, E14 4PU, UK.
Edward BlandfordUK Health Security Agency, 10 South Colonnade, Canary Wharf, London, E14 4PU, UK.
Elena TurekDeloitte MCS Ltd, London, UK.
Olumide KoladeUK Health Security Agency, 10 South Colonnade, Canary Wharf, London, E14 4PU, UK.
Sergio Souza da CunhaUK Health Security Agency, 10 South Colonnade, Canary Wharf, London, E14 4PU, UK.
Andrew DodgsonUK Health Security Agency, 10 South Colonnade, Canary Wharf, London, E14 4PU, UK.
Paul KlapperUK Health Security Agency, 10 South Colonnade, Canary Wharf, London, E14 4PU, UK.
Malur SudhanvaUK Health Security Agency, 10 South Colonnade, Canary Wharf, London, E14 4PU, UK.
Lindsey DaviesUK Health Security Agency, 10 South Colonnade, Canary Wharf, London, E14 4PU, UK.
Sue HillUK Health Security Agency, 10 South Colonnade, Canary Wharf, London, E14 4PU, UK.
Susan HopkinsUK Health Security Agency, 10 South Colonnade, Canary Wharf, London, E14 4PU, UK.
Tim PetoUniversity of Oxford, Oxford, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeIn April 2020, the UK Government implemented NHS Test and Trace to provide SARS-CoV-2 quantitative reverse transcription polymerase chain reaction (qRT-PCR) testing for the public, with nose-and-throat swabbing for samples performed by trained staff. Self-swabbing (SS) would allow rapid scale-up of testing capacity and access. Six studies were undertaken to determine whether SS was as effective for detecting SARS-CoV-2 as swabbing performed by trained staff.

methodsSix prospective studies were conducted between April-October 2020, using six swab/media combinations. Differences between assisted swabbing (AS) and SS were evaluated for concordance, positivity, sensitivity, cycle threshold (Ct) values and void rates. Statistical analysis was performed using 95% confidence intervals (CIs), paired t-tests and model-based methods.

resultsOverall, 3,253 individuals were recruited (median age 37 years, 49% female), with 2,933 having valid paired qRT-PCR results. Pooled concordance rate was 98% (95% CI: 96%, 99%). Positivity rate differences for SS (8.1%) and AS (8.4%) and differences in pooled sensitivities between SS (86%; 95% CI: 78%, 92%) and AS (91%; 95% CI: 78%, 96%) were nonsignificant. Both types of swabbing led to pooled void rates below 2% and strongly correlated Ct values. Age, sex and previous swabbing experience did not have a significant impact on concordance or sensitivity.

conclusionThe UK adopted a policy to promote self-testing for SARS-CoV-2 based on data demonstrating equivalence of SS versus AS. Positive outcomes with SS are likely generalisable to testing for other respiratory pathogens, and we consider self-sampling and self-testing essential for future pandemic preparedness.

Indexed as

COVID-19SARS-CoV-2Specimen HandlingAdultCOVID-19 Nucleic Acid TestingCOVID-19 TestingFemaleHumansMaleNosePharynxProspective StudiesSensitivity and SpecificityUnited KingdomCOVID-19PCRSelf-swabbingSelf-testingTesting programmeUnited Kingdom

Identifiers

PMID38856828
PMCPMC11271363

What OpenQuestion holds

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LicenceCC BY
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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.