title: Performance of rapid influenza H1N1 diagnostic tests: a meta-analysis.
abstract: BACKGROUND
  Following the outbreaks of 2009 pandemic H1N1 infection, rapid influenza diagnostic tests have been used to detect H1N1 infection. However, no meta-analysis has been undertaken to assess the diagnostic accuracy when this manuscript was drafted.
  
  
  METHODS
  The literature was systematically searched to identify studies that reported the performance of rapid tests. Random effects meta-analyses were conducted to summarize the overall performance.
  
  
  RESULTS
  Seventeen studies were selected with 1879 cases and 3477 non-cases. The overall sensitivity and specificity estimates of the rapid tests were 0·51 (95%CI: 0·41, 0·60) and 0·98 (95%CI: 0·94, 0·99). Studies reported heterogeneous sensitivity estimates, ranging from 0·11 to 0·88. If the prevalence was 30%, the overall positive and negative predictive values were 0·94 (95%CI: 0·85, 0·98) and 0·82 (95%CI: 0·79, 0·85). The overall specificities from different manufacturers were comparable, while there were some differences for the overall sensitivity estimates. BinaxNOW had a lower overall sensitivity of 0·39 (95%CI: 0·24, 0·57) compared with all the others (P-value <0·001), whereas QuickVue had a higher overall sensitivity of 0·57 (95%CI: 0·50, 0·63) compared with all the others (P-value = 0·005).
  
  
  CONCLUSIONS
  Rapid tests have high specificity but low sensitivity and thus limited usefulness.
authors: Division of Biostatistics, School of Public Health, The University of Minnesota at Twin Cities, Minneapolis, MN 55455, USA. chux0051@umn.edu
authors: Haitao
authors: H
authors: Chu
authors: Eric T
authors: ET
authors: Lofgren
authors: M Elizabeth
authors: ME
authors: Halloran
authors: Pei F
authors: PF
authors: Kuan
authors: Michael
authors: M
authors: Hudgens
authors: Stephen R
authors: SR
authors: Cole
mesh_terms: D003955:Diagnostic Tests, Routine / Q000379:methods*; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000302:isolation & purification*; D007251:Influenza, Human / Q000175:diagnosis* / Q000821:virology; D012680:Sensitivity and Specificity; D014773:Virology / Q000379:methods*