@article{Riccò_Ranzieri_Peruzzi_Valente_Marchesi_Bragazzi_Donelli_Balzarini_Ferraro_Gianfredi_Signorelli_2022, title={Antigen Detection Tests for SARS-CoV-2: a systematic review and meta-analysis on real world data}, volume={93}, url={https://mattioli1885journals.com/index.php/actabiomedica/article/view/11031}, DOI={10.23750/abm.v93i2.11031}, abstractNote={<p><em>Background and aim</em> Rapid antigen detection (RAD) tests on nasopharyngeal specimens have been recently made available for SARS-CoV-2 infections, and early studies suggested their potential utilization as rapid screening and diagnostic testing. The present systematic review and meta-analysis was aimed to assess available evidence and to explore the reliability of antigenic tests in the management of the SARS-CoV-2 pandemic.</p> <p><em>Materials and Methods.</em> We reported our meta-analysis according to the PRISMA statement. We searched Pubmed, Embase, and pre-print archive medRxiv.og for eligible studies published up to November 5<sup>th</sup>, 2020. Raw data included true/false positive and negative tests, and the total number of tests. Sensitivity and specificity data were calculated for every study, and then pooled in a random-effects model. Heterogeneity was assessed using the I<sup>2</sup> measure. Reporting bias was assessed by means of funnel plots and regression analysis.</p> <p><em>Results</em>. Based on 25 studies, we computed a pooled sensitivity of 72.8% (95%CI 62.4–81.3), a specificity of 99.4% (95%CI 99.0–99.7), with high heterogeneity and risk of reporting bias. More precisely, RAD tests exhibited higher sensitivity on samples with high viral load (i.e. <25 Cycle Threshold; 97.6%; 95%CI 94.1–99.0), compared to those with low viral load (≥25 Cycle Threshold; 43.6%; 95% 27.6-61.1).</p> <p><em>Discussion</em>. As the majority of collected reports were either cohort or case-control studies, deprived of preventive power analysis and often oversampling positive tests, overall performances may have been overestimated. Therefore, the massive referral to antigenic tests in place of RT-qPCR is currently questionable, and also their deployment as mass screening test may lead to intolerable share of missing diagnoses. On the other hand, RAD tests may find a significant role in primary care and in front-line settings (e.g. Emergency Departments). (www.actabiomedica.it)</p>}, number={2}, journal={Acta Biomedica Atenei Parmensis}, author={Riccò, Matteo and Ranzieri, Silvia and Peruzzi, Simona and Valente, Marina and Marchesi, Federico and Bragazzi, Nicola Luigi and Donelli, Davide and Balzarini, Federica and Ferraro, Pietro and Gianfredi, Vincenza and Signorelli, Carlo}, year={2022}, month={May}, pages={e2022036} }