UK government must urgently rethink lateral flow test roll out, warn experts

January 12, 2021

UK government plans to widen the roll out of the Innova lateral flow test without supporting evidence risks serious harm, warn experts in The BMJ today.

More than £1 billion have been spent on purchasing lateral flow tests, but Professor Jon Deeks and colleagues argue that the public is being misled about their accuracy, as well as the risks and implications of false negative results, and they call on the government urgently to change course.

Mass testing may be helpful and necessary in certain circumstances if delivered to high quality, they explain, but the Innova lateral flow test is not fit for this purpose.

For example, in the Liverpool pilot study, 60% of infected symptomless people went undetected, including 33% of those with high viral loads who are at highest risk of infecting others. And among students in Birmingham, only 3% of those who would have tested positive on the "gold standard" PCR test were detected.

Yet the government continues to claim that the Innova test detects 77%, they write, and has championed the use of negative tests to enable visiting relatives in care homes, returning to work or staying in school, despite known exposure to an infectious case.

The government is also relying on mathematical models rather than real world evaluations of testing. They argue that the models used rely on flawed assumptions about test performance and how results will affect human behaviour. "Together they tend to overestimate potential benefits and underestimate potential harms."

No one questions the need for evidence based approaches to covid 19 treatments and vaccines. Why then, in the face of so little evidence of benefit, and so much evidence of poor test performance, is the government pushing the rollout, they ask?

It seems at least plausible that this is because hundreds of millions of Innova testing kits were purchased before it was known how they would perform in people without symptoms and when administered by less than expert hands, they suggest. These tests are now sitting in warehouses around the country.

Given all of the above, they call on the government at least to pause the rollout of rapid asymptomatic testing using the Innova test, including its use in care homes, schools, communities and self-testing by untrained people at home, until clearer messaging on the risks of negative results can be developed.

They also ask for full documentation relating to Innova's approval, and for publication of full reports for all studies and models of the Innova test.

What's more, information materials should be revised to make explicit the extremely poor sensitivity of the Innova test for community and self-use among those without symptoms; and the aims, outcomes and full costings of mass testing of keyworkers, schoolchildren, university students, and care home visitors should be reviewed, they add.

"Finally, since testing makes no difference unless followed by appropriate action, the UK needs a national scheme to enable self-isolation of cases and contacts through support, including financial and accommodation for those in need," they conclude.
Peer reviewed? No

Evidence type: Data Analysis; Opinion S

ubjects: People


Related Test Performance Articles from Brightsurf:

Rapid test shows 'solid performance' for diagnosing infection around joint implants
The recently FDA-authorized alpha-defensin lateral flow test is a highly accurate, ten-minute test for diagnosis of periprosthetic joint infection (PJI) - a serious and costly complication of total joint replacement, reports a study in The Journal of Bone & Joint Surgery.

Performance test for neural interfaces
Freiburg researchers develop guidelines to standardize analysis of electrodes.

Cognitive performance - Better than our predecessors
We employ our cognitive skills daily to assimilate and process information.

Predicting sports performance with "big data"
Smartphones and wearable devices are not simple accessories for athletes.

All of the performance, none of the fuss: Nitrile hydrogenation done right
Researchers developed a nano-cobalt phosphide catalyst (nano-Co2P) for the hydrogenation of nitriles to primary amines.

Big ideas in performance management 2.0
Industrial-era performance management paradigms and practices are outdated and ineffective in the modern VUCA work environment.

Anticipating performance can hinder memory
Anticipating your own performance at work or school may hinder your ability to remember what happened before your presentation, a study from the University of Waterloo has found.

Want to optimize sales performance?
CATONSVILLE, MD, September 16, 2019- According to new research published in the INFORMS journal Marketing Science, companies can improve sales performance when they adjust sales commissions for the sale of more popular items.

Jump test tool to predict athletic performance
Researchers studying the impact of fatigue on athletic performance have developed prototype software that can enable coaches to predict when elite athletes will be too fatigued to perform at their best.

Assessing battery performance: Compared to what?
A team from the US Department of Energy's (DOE) Argonne National Laboratory, University of Warwick, OVO Energy, Hawaii National Energy Institute, and Jaguar Land Rover reviewed the literature on the various methods used around the world to characterize the performance of lithium-ion batteries to provide insight on best practices.

Read More: Test Performance News and Test Performance Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to