Carmen Figueroa|Cheryl Johnson|Nathan Ford|Anita Sands|Shona Dalal|Robyn Meurant|Irena Prat|Karin Hatzold|Willy Urassa|Rachel Baggaley
Reliability of HIV rapid diagnostic tests for self-testing compared with testing by health-care workers: a systematic review and meta-analysis
World Health Organization|World Health Organization|London School of Hygiene & Tropical Medicine|World Health Organization|World Health Organization|World Health Organization|World Health Organization|World Health Organization|World Health Organization|World Health Organization
h3backgroundh3 ability individuals use hiv selftests correctly debated inform 2016 recommendation hiv selftesting assessed reliability performance hiv rapid diagnostic tests used selftesters h3methodsh3 systematic review metaanalysis searched pubmed popline embase conference abstracts additional grey literature jan 1 1995 april 30 2016 observational experimental studies reporting hiv selftesting performance excluded studies evaluating home specimen collection patients interpret test results extracted data independently using standardised extraction forms outcomes interest agreement selftesters healthcare workers sensitivity specificity calculated establish level agreement pooled estimates using randomeffects model approach directly assisted unassisted type specimen blood oral fluid examined heterogeneity iiisup2sup statistic h3findingsh3 25 studies met inclusion criteria 22 5662 participants quality assessment quadas2 showed studies low risk bias incomplete reporting accordance stard checklist raw proportion agreement ranged 854 100 reported ranged fair 0277 p0001 almost perfect 099 n25 pooled suggested almost perfect agreement types approaches directly assisted 098 95 ci 096099 unassisted 097 096098 iiisup2sup345 0978 excluding two outliers sensitivity specificity higher bloodbased rapid diagnostic tests 416 compared oral fluid rapid diagnostic tests 1316 common error affected test performance incorrect specimen collection oral swab finger prick study limitations included use different reference standards disaggregation results individuals taking antiretrovirals h3interpretationh3 selftesters reliably accurately hiv rapid diagnostic tests compared trained healthcare workers errors performance might reduced improvement rapid diagnostic tests selftesting particularly make sample collection easier simplify instructions use h3fundingh3 bill melinda gates foundation unitaid