{"doi":"10.1128/spectrum.02525-23","title":"Self-administered versus clinician-performed BinaxNOW COVID rapid test: a comparison of accuracy","abstract":"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. IMPORTANCE Accurate and accessible COVID-19 testing is crucial for effective disease control and management. A recent single-center study conducted in Baltimore City examined the reliability of self-performed rapid antigen tests (RATs) for COVID-19. The study found that self-administered RATs yielded similar sensitivity and specificity to clinician-performed tests, demonstrating their comparable accuracy. These findings hold significant implications for physicians relying on patient-reported positive test results for treatment decisions. The study provides robust evidence supporting the reliability and utility of patient-performed RATs, endorsing their continued use in managing COVID-19. Furthermore, the study highlights the need for further research using different rapid antigen test brands to enhance generalizability. Ensuring affordable and widespread access to self-tests is crucial, particularly in preparation for future respiratory virus seasons and potential waves of reinfection of SARS-CoV-2 variants such as the Omicron variant.","journal":"Microbiology Spectrum","year":2024,"id":467289,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":3,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9536,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1299701,"name":"Minahil Cheema","orcid":"0000-0002-6923-1494","position":1,"is_corresponding":false},{"id":1300070,"name":"Sarah Omer","orcid":null,"position":2,"is_corresponding":false},{"id":947280,"name":"Ishaan Gupta","orcid":"0000-0003-2450-0029","position":3,"is_corresponding":false},{"id":947279,"name":"Kristie J. Sun","orcid":"0000-0002-3075-9064","position":4,"is_corresponding":false},{"id":947281,"name":"Asia Mitchell","orcid":"0000-0003-0969-1680","position":5,"is_corresponding":false},{"id":910449,"name":"Maryam Elhabashy","orcid":"0000-0003-1172-746X","position":6,"is_corresponding":false},{"id":947725,"name":"Maisha Foyez","orcid":null,"position":7,"is_corresponding":false},{"id":1300071,"name":"Aamna Cheema","orcid":null,"position":8,"is_corresponding":false},{"id":1299702,"name":"Binish Javed","orcid":"0000-0002-0847-7757","position":9,"is_corresponding":false},{"id":947723,"name":"Sophia Purekal","orcid":null,"position":10,"is_corresponding":false},{"id":1300072,"name":"Resham Rahat","orcid":null,"position":11,"is_corresponding":false},{"id":892038,"name":"Henry J. Michtalik","orcid":"0000-0002-1453-1473","position":12,"is_corresponding":false},{"id":947282,"name":"Charles Locke","orcid":"0000-0002-7689-6929","position":13,"is_corresponding":false},{"id":947283,"name":"Melinda E. Kantsiper","orcid":"0000-0002-1727-8928","position":14,"is_corresponding":false},{"id":37429,"name":"James D. Campbell","orcid":"0000-0002-2931-9643","position":15,"is_corresponding":false},{"id":804520,"name":"E. Adrianne Hammershaimb","orcid":"0000-0002-0823-275X","position":16,"is_corresponding":false},{"id":237961,"name":"Yukari C. Manabe","orcid":"0000-0001-8619-5598","position":17,"is_corresponding":false},{"id":108416,"name":"Matthew L. Robinson","orcid":"0000-0003-0376-8560","position":18,"is_corresponding":false},{"id":336852,"name":"J. Kristie Johnson","orcid":"0000-0001-8872-2291","position":19,"is_corresponding":false},{"id":218476,"name":"Lucy Wilson","orcid":"0000-0003-0092-1750","position":20,"is_corresponding":false},{"id":947726,"name":"Charles W. Callahan","orcid":null,"position":21,"is_corresponding":false},{"id":912532,"name":"Zishan K. Siddiqui","orcid":"0000-0002-8790-5958","position":22,"is_corresponding":false},{"id":947722,"name":"Mary Jane E. 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