A randomized controlled trial yesterday in JAMA Internal Medicine finds that adult consumers struggle to interpret and act on negative at-home COVID-19 tests.The US Food and Drug Administration (FDA) has authorized 11 at-home, rapid antigen tests, including instructions, for asymptomatic and symptomatic Americans as of December 2021, and the Biden administration began distributing the first of a planned 500 million free such tests in January.While COVID-19 rapid antigen tests produce results within 30 minutes, they are less sensitive (have more false-negative results) than polymerase chain reaction (PCR) tests, which have an estimated sensitivity of about 70%, the study authors noted.
Sensitivity is the probability that a test correctly identifies all positive cases."Therefore, users with a high pretest probability of disease should still quarantine even after receiving a negative test result," the researchers wrote. "If users ignore that probability, a negative test result may encourage behavior that is risky to them and others."64% of users had at least a college degreeSteven Woloshin, MD, of the Dartmouth Institute for Health Policy and Clinical Practice, led the April 2021 trial, which involved asking 338 US adults how they would interpret the results of their self-test using instructions authorized by the FDA, instructions developed using decision science principles, or no instructions.The FDA-authorized test instructions were provided by the individual test makers.In a JAMA audio interview, Woloshin said that when he was considering the study, he read the FDA-authorized instructions and thought they undermined users' intuition. "I thought the instructions were confusing and certainly weren't clear about what you