Background
Home rapid antigen tests (RATs) are widely available, partially due to government distribution programs. Time-sensitive clinical decisions about provision of ambulatory COVID-19 care can depend on the results of these studies, which are often more readily accessible than clinician-performed tests. It is assumed that the two are similarly accurate. However, few studies of self-test RAT accuracy exist. Here, we compare the accuracy of patient-performed and clinician-performed BinaxNOW RATs using PCR as a gold standard.

Methods
All adult patients between February 12, 2022 and May 18, 2022 at a free state testing site in Baltimore, USA, were offered enrollment. Demographic and symptom status were recorded. 3 samples were obtained from each participant: clinicians sampled bilateral nares for PCR and RAT, after which participants self-tested using identical RATs. Sensitivity and specificity were compared using Chi-square. 

Results
625 patients participated. 60.6% were female, 58.6% were white, 98.2% were English speaking, and median age was 34 (IQR: 28, 48.5). 34.1% were symptomatic and 14.9% were PCR positive by PCR. Clinician and self-performed RATs had similar sensitivity (88.2% [95% CI: 80.1%, 93.2%] vs 83.9% [95% CI: 75.1%, 90.0%] P= 0.40) and specificity (99.6% [95% CI: 98.5%, 99.9%] vs 99.8% [95% CI: 98.8%, 100%] P= 0.57). In symptomatic patients, self-test had a sensitivity of 94.5% (95% CI: 86.6-98.5) and specificity of 62.5% (95% CI: 24.5-91.5). For asymptomatic patients, self-test had a sensitivity of 66.7% (95% CI: 29.9-92.5) and specificity of 100% (95% CI: 29.2-100.0). These were similar to clinical PCR as well. 

Conclusion
Clinician-performed and self-performed RATs had similarly high accuracy. The high observed sensitivity of home RATs supports their continued usage in ambulatory decision-making to identify eligible candidates for COVID-19 therapeutics. Their accessibility is key, since federal policy now states that patients are treatment eligible for a maximum of 7 days. Self-performed RATs reduce barriers including time needed to search for and then attend clinician appointments, and allow patients to play a larger role in their own care. Low false positive rates mitigate concerns about poor technique or contamination, and ensure that treatment is appropriate. Our study supports continued use of home RATs for clinical decision making.

Comparison of Accuracy of Self-Test and Clinical Rapid Antigen Testing for Coronavirus-19 (COVID-19)

Public Health and Health Policy | Advocacy and Health Equity / Public Health / Data Science Health Systems

poster

Welcome to the largest national, multi-specialty research event **featuring research from 750 medical students, residents and fellows, and international medical graduates.**


#### Event Details
The 2022 American Medical Association Research Challenge includes a poster symposium hall and a semifinals hall with the top scored research. Log in at any time throughout the event to:
* **View posters and presentations** on a variety of topics and specialties
* **Score posters in the semifinals** to help decide the top five finalists (AMA member exclusive opportunity)
* **Connect with participants** and provide feedback to help advance their research

At the conclusion of this event, the AMA will announce the top five finalists who will advance to the AMA Research Challenge finals, present their research to an elite panel of judges and compete to win a $10,000 grand prize sponsored by Laurel Road.
 

#### Attend Live Forums
**Oct. 20, 6 — 7 p.m. Central**
 **How to plan a career in academic medicine** 
 Learn how to plan a career in academic medicine and get your questions answered. [Access Here](https://underline.io/events/363/lounge)
 
 **Speakers**
![](https://assets.underline.io/uploads/markdown_image/1/image/d5adb133dfc58eb0a6d469e9cedcd5d4.jpg)
Ricardo Correa, MD, EdD
![](https://assets.underline.io/uploads/markdown_image/1/image/5f9437ab87861538bf02b9ca7c0d926e.jpg)
Stuart M. Greenstein, MD
![](https://assets.underline.io/uploads/markdown_image/1/image/05b1b637c99286d558c371f8e8b185ce.jpg)
Stephanie Strohbeen, MD
 
 **Oct. 22, 11 a.m. — Noon Central**
 **How to get published**
 Learn tips to get your research published and get your questions answered. [Access Here](https://underline.io/events/363/lounge)
 
 **Speakers**
![](https://assets.underline.io/uploads/markdown_image/1/image/8ce6235e957d31cb5e6f9097cc6f6972.jpg)
Jessica Li, MD/PhD Candidate
![](https://assets.underline.io/uploads/markdown_image/1/image/9950ef2e0237f54cb3d8280334d42491.jpg)
Charles Lopresto, DO

### Sponsor
AMA would like to thank Laurel Road for sponsoring a $10,000 grand prize for the winner of the AMA Research Challenge. Laurel Road is not involved in the judging or scoring process to select the winner. The winner will be announced on Dec. 7 during the AMA Research Challenge finals. Payment of the grand prize will be directly from Laurel Road. See the AMA Research Challenge Official Rules for terms and conditions.

![](https://assets.underline.io/uploads/markdown_image/1/image/611e331d4a0eba0920f240cfc04b4d77.png)

**There is no registration fee for this event! **

Register to explore research in a variety of topics. AMA members get exclusive access to score posters in the semifinals.

**Please use the link below to register for free if you have not already done so:**

https://www.ama-assn.org/about/events/ama-research-challenge

Registration Is Required

AMA Research Challenge 2022

Welcome to the largest national, multi-specialty research event featuring research from 750 medical students, residents and fellows, and international medical graduates.


Kristie Sun

1

SHORT BIO

Presentations

Comparison of Accuracy of Self-Test and Clinical Rapid Antigen Testing for Coronavirus-19 (COVID-19)

Stay up to date with the latest Underline news!

PRESENTATIONS

CONFERENCES

COMPANY

RESOURCES