Effectiveness and user experience of nose and throat swabbing techniques for SARS-CoV-2 detection: results from the UK COVID-19 National Testing Programme

Futschik, Matthias E.; Kulasegaran-Shylini, Raghavendran; Blandford, Edward; Harper, Sean; Chapman, David; Turek, Elena; Agrawal, Somya; Phillips, Valerie; Fordham, Hannah; Chan, Lee; Kidd, Mike; Dodgson, Andrew; Klapper, Paul E.; Sudhanva, Malur; Vipond, Richard; Hopkins, Susan; Peto, Tim; Tunkel, Sarah; Fowler, Tom

doi:10.1186/s44263-024-00121-x

Table 1 Overview of the service evaluations

From: Effectiveness and user experience of nose and throat swabbing techniques for SARS-CoV-2 detection: results from the UK COVID-19 National Testing Programme

	Study start date	Test type	LFD test	Swabbing technique	Number recruited	Evaluable paired samples	Concordant samples, % (95% CI)	Sensitivity (vs. control), % (95% CI)		Specificity (vs. control), % (95% CI)
Self-swabbing nose-only studies
SS-AN-PCR1	Sep 2020	SS PCR	N/A	Anterior nares	2169	2083	97.1 (96.3–97.8)	88.1 (84.4–91.2)		99.1 (98.5–99.5)
SS-AN-LFD1 [20]	Jan 2021	SS LFD	Orient Gene	Anterior nares	1877	1788	89.4 (87.9–90.8)	53.3 (48.1–58.4)		99.3 (98.7–99.7)
SS-AN-LFD2	Feb 2021	SS LFD	SureScreen	Anterior nares	2524	2394	96.3 (95.5–97.0)	71.0 (65.5–76.0)		100.0 (99.8–100.0)
SS-AN-LFD3^a	Jul 2021	SS LFD	SureScreen	Anterior nares	1534	1499	93.6 (92.2–94.8)	74.7 (69.9–79.1)		99.7 (99.1–99.9)
SS-AN-LFD4^a	Aug 2021	SS LFD	Innova LFD	Anterior nares	6591	3990	95.3 (94.6–95.0)	74.9 (71.4–78.2)		99.2 (98.9–99.5)
SS-MT-LFD1 [34]	Jun 2021	SS LFD	Innova LFD	Mid-turbinate	1156	1102	91.8 (90.0–93.4)	72.9 (67.7–77.7)		99.7 (99.1–100.0)
Self-swabbing nose and throat studies
SS-NT-LFD1 [18, 33, 35]	Nov 2020	SS LFD	Innova LFD	Nose and throat	2582	2473	90.6 (89.4–91.7)	50.0 (45.1–54.9)	99.1 (98.6–99.4)
SS-NT-LFD2 [34]	May 2021	SS LFD	Innova LFD	Nose and throat	635	631	65.8 (61.9–69.5)	65.8 (61.9–69.5)	N/A
SS-NT-LFD3^a	Feb 2021	SS LFD	Innova LFD	Nose and throat	957	773	95.2 (93.5–96.6)	56.8 (44.3–67.8)	99.7 (99.0–100.0)
Assisted swabbing studies
AS-AN-LFD1 [20]	Jan 2021	AS LFD	Orient Gene	Anterior nares	2635	2597	92.8 (91.8–93.8)	53.2 (48.1–58.3)	99.8 (99.5–100.0)
AS-AN-LFD1 [20]	Jan 2021	AS LFD	Orient Gene	Nose and throat	2635	2598	93.8 (92.8–94.7)	59.6 (54.6–64.6)	99.8 (99.5–99.9)
AS-AN-LFD2	Nov 2021	AS LFD	Innova LFD	Anterior nares	1226	1160	89.2 (87.3–91.0)	57.6 (51.6–63.4)	99.4 (98.7–99.8)
AS-NT-LFD1 [18, 20, 33, 35]	Nov 2020	AS LFD	Innova LFD	Nose and throat	4356	4225	92.2 (91.3–93.0)	54.4 (50.6–58.2)	99.6 (99.3–99.8)

AN anterior nares, AS assisted swabbing, CI confidence interval, LFD lateral flow device, MT mid-turbinate, N/A not applicable, NT nose and throat, PCR polymerase chain reaction, qRT-PCR quantitative reverse transcription polymerase chain reaction, SS self-swabbing
^aEffectiveness of LFD tested at participants’ homes
Nose and throat sampling for qRT-PCR (either SS or AS) was the control for each service evaluation. Sensitivity = TP/(TP + FN) based on corresponding qRT-PCR test results; binomial 95% CIs, Pearson-Klopper method

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ISSN: 2731-913X

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