As communities across the world are struggling to cope with the effects of the COVID-19 pandemic, concern has shifted to testing accuracy, predominantly with antibody tests, which are designed to identify prior infections.

A study published in the New England Journal of Medicine stated that more emphasis should be placed on addressing the inaccuracy of diagnostic tests which play a key role in containing the pandemic.

The lead author and a Professor of Medicine and Community and Family Medicine at Dartmouth Geisel School of Medicine, Steven Woloshin, said, a false-positive result mistakenly labelled a person infected, with consequences including unnecessary quarantine and contact tracing.

Prof. Woloshin said, “False-negative results are far more consequential because infected persons who might be asymptomatic may not be isolated and can infect others.”

Woloshin and his colleagues in their papers discuss factors contributing to the current limitations of diagnostic tests, including variability in test sensitivity and the lack of a standard process for validating test accuracy.

The researchers drew several conclusions from their work, saying diagnostic testing would help to safely open the country, but that only if the tests were highly sensitive and validated against a clinically meaningful reference standard “otherwise we cannot confidently declare people uninfected.”

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