High false-negative rate limits value of rapid COVID tests for kids

A meta-analysis published this week in BMJ shows that COVID-19 rapid antigen tests for children don't meet minimum performance standards set by the World Health Organization (WHO) and the US Food and Drug Administration (FDA).Already shown to be far less sensitive in adults than their manufacturers report, rapid antigen tests, also called lateral flow tests, are widely used in children to screen for COVID-19 in schools, homes, and healthcare settings.

Amid scarcity of the over-the-counter tests, US households can now order four such tests from a US government website for free.While experts say these nasal-swab tests—sold under brand names such as BinaxNOW and BD Veritor—have some value in disrupting virus transmission, it's important to understand their limitations—especially amid the current surge of cases caused by the highly transmissible and evasive Omicron (B.1.1.529) variant."I think an important point to remember is that with rapid antigen tests, positive results are generally meaningful, but negative results have to be taken with a grain of salt," Kelly Wroblewski, MPH, director of infectious diseases at the Association of Public Health Laboratories, told CIDRAP News.Michael Osterholm, PhD, MPH, director of the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota, publisher of CIDRAP News, calls interpreting negative test results "a huge challenge.""The average consumer isn't going to know what this means.

Many people will get a negative result and go to dinner with Grandma and Grandpa."Poor sensitivity, acceptable specificityIn the first meta-analysis of its kind, a team led by University of Manchester researchers in the United Kingdom evaluated 17 studies involving 6,355