Self-administered versus clinician-performed BinaxNOW COVID rapid test: a comparison of accuracy
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Vaeth, Mary Jane E., Minahil Cheema, Sarah Omer, Ishaan Gupta, Kristie J. Sun, Asia Mitchell, Maryam Elhabashy, et al. “Self-Administered versus Clinician-Performed BinaxNOW COVID Rapid Test: A Comparison of Accuracy.” Microbiology Spectrum 0, no. 0 (February 13, 2024): e02525-23. https://doi.org/10.1128/spectrum.02525-23.
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CC BY 4.0 DEED Attribution 4.0 International
CC BY 4.0 DEED Attribution 4.0 International
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Abstract
We conducted a single-center study at a free community testing site in Baltimore City to assess the accuracy of self-performed rapid antigen tests (RATs) for COVID-19. Self-administered BinaxNOW RATs were compared with clinician-performed RATs and against a reference lab molecular testing as the gold standard. Of the 953 participants, 14.9% were positive for SARS- CoV-2 as determined by RT-PCR. The sensitivity and specificity were similar for both self- and clinician-performed RATs (sensitivity: 83.9% vs 88.2%, P = 0.40; specificity: 99.8% vs 99.6%, P = 0.6). Subgroup comparisons based on age and race yielded similar results. Notably, 5.2% (95% CI: 1.5% to 9.5%) of positive results were potentially missed due to participant misinterpretation of the self-test card. However, the false-positive rate for RATs was reassuringly comparable in accuracy to clinician-administered tests. These findings hold significant implications for physicians prescribing treatment based on patient-reported, self-administered positive test results. Our study provides robust evidence supporting the reliability and utility of patient-performed RATs, underscoring their comparable accuracy to clinician-performed RATs, and endorsing their continued use in managing COVID-19. Further studies using other rapid antigen test brands are warranted.