Evidence map›Paper›PMID 42877135›Full record

ArticleBMJ public health2026

Large-scale COVID-19 asymptomatic testing using lateral flow devices (LFDs) in reducing nosocomial infections and healthcare worker absenteeism: an observational study and cost-effectiveness analysis in NHS acute trusts in England.

Siyu Chen, Rachel Hounsell, Liberty Cantrell, Lok Hei Tsui, Reshania Naidoo, Prabin Dahal, Richard Creswell, Sumali Bajaj, Jennifer A Flegg, Tom Fowler and 7 more

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Article in BMJ public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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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

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3 · Its place in the literature

Who cites it

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No citing paper in PubMed yet.

4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

17 authors.

Siyu ChenDepartment of Health Data Science, University of Liverpool, Liverpool, UK.ORCID https://orcid.org/0000-0001-9418-2527
Rachel HounsellNuffield Department of Medicine, University of Oxford, Oxford, UK.ORCID https://orcid.org/0000-0003-1393-4294
Liberty CantrellDepartment of Paediatrics, University of Oxford, Oxford, UK.ORCID https://orcid.org/0000-0001-5413-7641
Lok Hei TsuiDepartment of Biology, University of Oxford, Oxford, UK.
Reshania NaidooNuffield Department of Medicine, University of Oxford, Oxford, UK.
Prabin DahalNuffield Department of Medicine, University of Oxford, Oxford, UK.ORCID https://orcid.org/0000-0002-2158-846X
Richard CreswellDepartment of Computer Science, University of Oxford, Oxford, UK.
Sumali BajajDepartment of Biology, University of Oxford, Oxford, UK.
Jennifer A FleggUniversity of Melbourne School of Mathematics and Statistics, Parkville, Victoria, Australia.
Tom FowlerUK Health Security Agency, London, UK.
Susan HopkinsUK Health Security Agency, London, UK.
Ben LambertDepartment of Statistics, University of Oxford, Oxford, UK.
Merryn VoyseyDepartment of Paediatrics, University of Oxford, Oxford, UK.
Lisa WhiteDepartment of Biology, University of Oxford, Oxford, UK.
Kasia StepniewskaUniversity of Oxford, Oxford, UK.
Rima ShrettaNuffield Department of Medicine, University of Oxford, Oxford, UK.
EY-Oxford Health Analytics Consortium

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Twice-weekly lateral flow device (LFD) testing for asymptomatic healthcare workers (HCWs) was introduced in the National Health Service (NHS) in England in November 2020. We retrospectively examine associations between LFD testing, nosocomial infections and HCW absenteeism at NHS acute trusts. Methods: We collected 16 million LFD testing results reported by NHS acute trusts from 1 October 2020 to 30 March 2022 and estimated the prevalence of nosocomial COVID-19 infections in NHS acute trusts using data from the International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC). We used a mixed-effects linear model to examine the association between full-time equivalent (FTE) days lost due to COVID-19 and LFD test coverage. The relationship between weekly prevalence of nosocomial infections and LFD test coverage in the previous week was modelled using logistic regression weighted by the number of new COVID-19 cases reported in the ISARIC dataset for that week. We conducted an analysis of cost-effectiveness of testing for nosocomial infections. Results: Increased LFD test coverage was associated with decreases in FTE days lost due to COVID-19 from November 2020 to July 2021, with no association observed from August 2021 to March 2022. The proportion of nosocomial infections among new weekly cases in hospitalised patients was negatively associated with reported LFD testing levels. Conclusions: Higher LFD test coverage was associated with lower HCW absenteeism (November 2020-July 2021) and with a lower proportion of nosocomial infections among hospitalised patients. Given the retrospective, ecological design, these are associations rather than causal effects, and the cost-effectiveness estimates are valid only if the observed association reflects a causal effect of testing rather than confounding by co-occurring interventions or temporal trends in the pandemic. Under that assumption, LFD testing would have been a cost-effective measure for reducing nosocomial infections in NHS acute trusts.

Indexed as

Community HealthCOVID-19Public Health

Identifiers

PMID42877135
PMCPMC13662036

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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.