Summarizing Study Characteristics and Diagnostic Performance of Commercially Available Tests for Respiratory Syncytial Virus: A Scoping Literature Review in the COVID-19 Era

  1. David I Bernstein
  2. Asuncion Mejias
  3. Barbara Rath
  4. Christopher W Woods
  5. Jamie Phillips Deeter

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Abstract

Background

Nonpharmaceutical interventions to prevent the spread of coronavirus disease 2019 also decreased the spread of respiratory syncytial virus (RSV) and influenza. Viral diagnostic testing in patients with respiratory tract infections (RTI) is a necessary tool for patient management; therefore, sensitive and specific tests are required. This scoping literature review aimed to summarize the study characteristics of commercially available sample-to-answer RSV tests.

Content

PubMed and Embase were queried for studies reporting on the diagnostic performance of tests for RSV in patients with RTI (published January 2005–January 2021). Information on study design, patient and setting characteristics, and published diagnostic performance of RSV tests were extracted from 77 studies that met predefined inclusion criteria. A literature gap was identified for studies of RSV tests conducted in adult-only populations (5.3% of total subrecords) and in outpatient (7.5%) or household (0.8%) settings. Overall, RSV tests with analytical time >30 min had higher published sensitivity (62.5%–100%) vs RSV tests with analytical time ≤30 min (25.7%–100%); this sensitivity range could be partially attributed to the different modalities (antigen vs molecular) used. Molecular-based rapid RSV tests had higher published sensitivity (66.7%–100%) and specificity (94.3%–100%) than antigen-based RSV tests (sensitivity: 25.7%–100%; specificity:80.3%–100%).

Summary

This scoping review reveals a paucity of literature on studies of RSV tests in specific populations and settings, highlighting the need for further assessments. Considering the implications of these results in the current pandemic landscape, the authors preliminarily suggest adopting molecular-based RSV tests for first-line use in these settings.

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  1. Version published to 10.1093/jalm/jfac058
  2. ScreenIT

    SciScore for 10.1101/2022.02.14.22270927: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Ethicsnot detected.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    PubMed (https://pubmed.ncbi.nlm.nih.gov/) and Embase (https://www.embase.com/) were interrogated on January 21, 2021 using the search terms and criteria in Supplemental Table 1 to identify studies reporting on the sensitivity and specificity of commercially available sample-to-answer tests for RSV in patients with acute respiratory infection published between January 2005 and January 2021.
    PubMed
    suggested: (PubMed, RRID:SCR_004846)
    Embase
    suggested: (EMBASE, RRID:SCR_001650)
    https://www.embase.com/
    suggested: (Embase Biomedical Answers, RRID:SCR_008498)
    Data Reporting: All data handling was carried out using Microsoft Excel 365 (Microsoft Corporation).
    Microsoft Excel
    suggested: (Microsoft Excel, RRID:SCR_016137)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    An inherent limitation of scoping reviews is that the data synthesis is based on the values extracted from any given study; therefore, results may not be comparable in terms of methodology, limiting the meaningful conclusions that can be drawn from differences in the sensitivity and specificity between RSV tests from different studies. However, the purpose of this scoping review was not to analyze but to summarize the published data available. Future research should assess the sensitivity and specificity of RSV tests in adult populations and in outpatient and household settings. In addition, studies should control for selection bias and adjust for differences in settings where the RSV test was performed, seasonality, and staff utilization of RSV tests. The use of POC testing for influenza and RSV across four centers in Denmark resulted in a significant reduction in antibiotic prescription and median hospitalization time in adults (44.3 hours) and children (14.2 hours), there was also an increase in the use of antiviral treatment in adults only (18). These positive results indicate that further studies are warranted to explore the effects of testing for RSV on patient outcomes (43). In conclusion, different clinical situations (e.g., the clinical laboratory of a large hospital vs an outpatient clinic) will require different diagnostic solutions. Given the higher sensitivity and specificity of molecular-based testing over antigen-based modalities for RSV infection, rRT-PCR test...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

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  3. Version published to 10.1101/2022.02.14.22270927v1 on medRxiv