Escaping the COVID-19 Testing Paradox
6 Pages Posted: 8 Jun 2020
Date Written: May 28, 2020
As with all diagnostic tests, PCR and serology tests are imperfect, sometimes producing false negatives and sometimes false positives. While the sensitivity and specificity of these tests can be measured, their positive and negative predictive values are inextricably linked to the cumulative incidence of the disease, which remains unknown. Paradoxically, a false belief in a much lower prior probability of disease, now called into question by population-based studies, may lead to underestimating predictive value of serology testing. In order to implement testing strategies that will underpin opening up the economy, regular and repeated measurement on both individuals and populations is needed. Strategies using multiple tests can improve predictive value.
Note: Funding: Supported by grant U01HL121518 from the NIH/NHLBI.
Declaration of Interest: KDM is on the Scientific Advisory Board of Medal, Inc. KDM's program at Boston Children’s Hospital receives sponsored research support and philanthropy from Quest Diagnostics. AKM is a co-founder and adviser of XY.ai.
Keywords: COVID-19, infectious disease, positive predictive value, serological testing
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