Evidence map›Paper›PMID 39814453›Full record

ArticleEmergency medicine journal : EMJ2025

Multiplex lateral flow test sensitivity and specificity in detecting influenza A, B and SARS-CoV-2 in adult patients in a UK emergency department.

Rahul Batra, Edward Blandford, Raghavendran Kulasegaran-Shylini, Matthias E Futschik, Abbie Bown, Matthew Catton, Hermione Conti-Frith, Alexandra Alexandridou, Rebecca Gill, Clara Milroy and 11 more

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Article in Emergency medicine journal : EMJ, 2025. 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. 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

21 authors.

Rahul Batra *Department of Infectious Diseases, St Thomas' Hospital, London, UK cidr-noe@gstt.nhs.uk.ORCID http://orcid.org/0009-0000-0099-9692
Edward Blandford *UK Health Security Agency, London, UK.ORCID http://orcid.org/0000-0002-8846-2650
Raghavendran Kulasegaran-ShyliniUK Health Security Agency, London, UK.ORCID http://orcid.org/0000-0003-4303-5716
Matthias E FutschikUK Health Security Agency, London, UK.
Abbie BownUK Health Security Agency Porton, Salisbury, UK.
Matthew CattonUK Health Security Agency Porton, Salisbury, UK.
Hermione Conti-FrithUK Health Security Agency Porton, Salisbury, UK.
Alexandra AlexandridouUK Health Security Agency Porton, Salisbury, UK.
Rebecca GillUK Health Security Agency Porton, Salisbury, UK.
Clara MilroyUK Health Security Agency Porton, Salisbury, UK.
Sean HarperUK Health Security Agency, London, UK.
Holly GettingsEmergency Department, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Maryann NoronhaEmergency Department, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Hooi-Ling HarrisonEmergency Department, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Sam DouthwaiteDepartment of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Gaia NebbiaDepartment of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Paul E KlapperUK Health Security Agency, London, UK.
Sarah TunkelUK Health Security Agency, London, UK.
Richard VipondUK Health Security Agency Porton, Salisbury, UK.
Susan HopkinsUK Health Security Agency, London, UK.
Tom FowlerUK Health Security Agency, London, UK.ORCID http://orcid.org/0000-0002-7258-2279

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRapid identification of individuals with acute respiratory infections is crucial for preventing nosocomial infections. For rapid diagnosis, especially in EDs, lateral flow devices (LFDs) are a convenient, inexpensive option with a rapid turnaround. Several 'multiplex' LFDs (M-LFDs) now exist, testing for multiple pathogens from a single swab sample. We evaluated the real-world performance of M-LFD versus PCR testing in detecting influenza A, B and SARS-CoV-2) in the ED setting.

methodsAfter preliminary evaluation of an M-LFD (SureScreen) with laboratory-grown virus and PCR-negative clinical samples, it was evaluated in a real-world setting at the ED of St Thomas' Hospital (London, UK) from 1 December 2022 to 21 April 2023. Eligible participants were ≥18 years of age, admitted with respiratory symptoms and received concurrent M-LFD and PCR tests. Main endpoints were sensitivity to detect influenza A/B (primary) and SARS-CoV-2 (secondary) versus PCR. The probability of a true positive in relation to viral concentration (expressed as PCR cycle threshold (Ct)) was analysed using logistic regression.

resultsIn total, 808 symptomatic participants were included (49.8% female; mean age 46.9 years). Test sensitivity (95% CI) was 67.0% (56.9% to 76.1%) for influenza A (n=100), 94.1% (71.3% to 99.9%) for influenza B (n=17) and 48.2% (39.7% to 56.8%) for SARS-CoV-2 (n=141). Sensitivity for SARS-CoV-2 was significantly lower than that for influenza A and B (p=0.0057 and p=0.00088, respectively). The probability of a true positive was 98% for Ct<25 for influenza A and SARS-CoV-2 (influenza B non-evaluable). No co-infections were identified by PCR or M-LFD.

conclusionThe real-world performance of SureScreen M-LFD was consistent with laboratory evaluation and achieved a high sensitivity for individuals with high viral concentration, most likely to be infectious. Given the representative UK population sample, results could be generalised for use in other settings.

Indexed as

COVID-19Influenza, HumanAdultAgedEmergency Service, HospitalFemaleHumansInfluenza A virusInfluenza B virusMaleMiddle AgedSARS-CoV-2Sensitivity and SpecificityUnited KingdomCOVID-19Diagnostic Testsemergency departmentrespiratory

Identifiers

PMID39814453
PMCPMC11874347

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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.