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Diagnostic accuracy of autoverification and guidance system for COVID-19 RT-PCR results.
Cai, Yingmu; Liu, Mengyu; Wu, Zhiyuan; Tian, Cuihong; Qiu, Song; Li, Zhen; Xu, Feng; Li, Wei; Zheng, Yan; Xu, Aijuan; Xie, Longxu; Tan, Xuerui.
Afiliación
  • Cai Y; Joint Laboratory of Shantou University Medical College and Guangdong Hybribio Biotech Ltd, Shantou University Medical College, Shantou, 515041 Guangdong China.
  • Liu M; Hybribio Medical Laboratory Group Ltd, Chaozhou, 521000 Guangdong China.
  • Wu Z; Clinical Research Centre, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China.
  • Tian C; Joint Laboratory of Shantou University Medical College and Guangdong Hybribio Biotech Ltd, Shantou University Medical College, Shantou, 515041 Guangdong China.
  • Qiu S; Clinical Research Centre, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China.
  • Li Z; Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, 100069 China.
  • Xu F; Centre for Precision Health, Edith Cowan University, Perth, WA 6027 Australia.
  • Li W; Clinical Research Centre, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China.
  • Zheng Y; Centre for Precision Health, Edith Cowan University, Perth, WA 6027 Australia.
  • Xu A; Department of Cardiovascular Medicine, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China.
  • Xie L; Hybribio Medical Laboratory Group Ltd, Chaozhou, 521000 Guangdong China.
  • Tan X; Human Papillomavirus Molecular Diagnostic Engineering Technology Research Centre, Chaozhou, 521000 Guangdong China.
EPMA J ; 14(1): 119-129, 2023 Mar.
Article en En | MEDLINE | ID: mdl-36540610
Background: To date, most countries worldwide have declared that the pandemic of COVID-19 is over, while the WHO has not officially ended the COVID-19 pandemic, and China still insists on the personalized dynamic COVID-free policy. Large-scale nucleic acid testing in Chinese communities and the manual interpretation for SARS-CoV-2 nucleic acid detection results pose a huge challenge for labour, quality and turnaround time (TAT) requirements. To solve this specific issue while increase the efficiency and accuracy of interpretation, we created an autoverification and guidance system (AGS) that can automatically interpret and report the COVID-19 reverse transcriptase-polymerase chain reaction (RT-PCR) results relaying on computer-based autoverification procedure and then validated its performance in real-world environments. This would be conductive to transmission risk prediction, COVID-19 prevention and control and timely medical treatment for positive patients in the context of the predictive, preventive and personalized medicine (PPPM). Methods: A diagnostic accuracy test was conducted with 380,693 participants from two COVID-19 test sites in China, the Hong Kong Hybribio Medical Laboratory (n = 266,035) and the mobile medical shelter at a Shanghai airport (n = 114,658). These participants underwent SARS-CoV-2 RT-PCR from March 28 to April 10, 2022. All RT-PCR results were interpreted by laboratorians and by using AGS simultaneously. Considering the manual interpretation as gold standard, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy were applied to evaluate the diagnostic value of the AGS on the interpretation of RT-PCR results. Results: Among the 266,035 samples in Hong Kong, there were 16,356 (6.15%) positive, 231,073 (86.86%) negative, 18,606 (6.99%) indefinite, 231,073 (86.86%, negative) no retest required and 34,962 (13.14%, positive and indefinite) retest required; the 114,658 samples in Shanghai consisted of 76 (0.07%) positive, 109,956 (95.90%) negative, 4626 (4.03%) indefinite, 109,956 (95.90%, negative) no retest required and 4702 (4.10%, positive and indefinite) retest required. Compared to the fashioned manual interpretation, the AGS is a procedure of high accuracy [99.96% (95%CI, 99.95-99.97%) in Hong Kong and 100% (95%CI, 100-100%) in Shanghai] with perfect sensitivity [99.98% (95%CI, 99.97-99.98%) in Hong Kong and 100% (95%CI, 100-100%) in Shanghai], specificity [99.87% (95%CI, 99.82-99.90%) in Hong Kong and 100% (95%CI, 99.92-100%) in Shanghai], PPV [99.98% (95%CI, 99.97-99.99%) in Hong Kong and 100% (95%CI, 99.99-100%) in Shanghai] and NPV [99.85% (95%CI, 99.80-99.88%) in Hong Kong and 100% (95%CI, 99.90-100%) in Shanghai]. The need for manual interpretation of total samples was dramatically reduced from 100% to 13.1% and the interpretation time fell from 53 h to 26 min in Hong Kong; while the manual interpretation of total samples was decreased from 100% to 4.1% and the interpretation time dropped from 20 h to 16 min at Shanghai. Conclusions: The AGS is a procedure of high accuracy and significantly relieves both labour and time from the challenge of large-scale screening of SARS-CoV-2 using RT-PCR. It should be recommended as a powerful screening, diagnostic and predictive system for SARS-CoV-2 to contribute timely the ending of the COVID-19 pandemic following the concept of PPPM.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Diagnostic_studies / Guideline / Prognostic_studies Idioma: En Revista: EPMA J Año: 2023 Tipo del documento: Article Pais de publicación: Suiza

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Diagnostic_studies / Guideline / Prognostic_studies Idioma: En Revista: EPMA J Año: 2023 Tipo del documento: Article Pais de publicación: Suiza