title: Sensitivity and specificity of the AdenoPlus point-of-care system in detecting adenovirus in conjunctivitis patients at an ophthalmic emergency department: a diagnostic accuracy study.
abstract: BACKGROUND
  To estimate the diagnostic accuracy (sensitivity and specificity) of the AdenoPlus point-of-care adenoviral test compared to PCR in an ophthalmic accident and emergency service. These findings were compared with those of a previous study.
  
  
  METHODS
  This was a prospective diagnostic accuracy study on 121 patients presenting to an emergency eye unit with a clinical picture of acute adenoviral conjunctivitis. AdenoPlus testing was carried out on one eye of each patient and a PCR analysis was also performed on a swab taken from the same eye. AdenoPlus and PCR results were interpreted by masked personnel. Sensitivity and specificity for the AdenoPlus test were calculated using PCR results as the reference standard.
  
  
  RESULTS
  121 patients were enrolled and 109 met the inclusion criteria. 43 patients (39.4%) tested positive for adenovirus by PCR analysis. The sensitivity of the AdenoPlus swab in detecting adenovirus was 39.5% (17/43, 95% CI 26% to 54%) and specificity was 95.5% (63/66, 95% CI 87% to 98%) compared to PCR.
  
  
  CONCLUSIONS
  The AdenoPlus test has a high specificity for diagnosing adenoviral conjunctivitis, but in this clinical setting, we could not reproduce the high sensitivity that has been previously published.
authors.affiliation: Moorfields Eye Hospital, London, UK Faculty of Medicine, Department of Surgery and Cancer, Imperial College London, London, UK.
authors.forename: K Y Ronald
authors.initials: KY
authors.lastname: Kam
authors.affiliation: Moorfields Eye Hospital, London, UK.
authors.forename: Hon Shing
authors.initials: HS
authors.lastname: Ong
authors.affiliation: National Institute for Health Research Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK.
authors.forename: Catey
authors.identifier: http://orcid.org/0000-0002-0935-3713
authors.initials: C
authors.lastname: Bunce
authors.affiliation: Moorfields Eye Hospital, London, UK.
authors.forename: Lola
authors.initials: L
authors.lastname: Ogunbowale
authors.affiliation: Moorfields Eye Hospital, London, UK.
authors.forename: Seema
authors.initials: S
authors.lastname: Verma
mesh_terms: D000208:Acute Disease; D000258:Adenovirus Infections, Human / Q000175:diagnosis*; D000260:Adenoviruses, Human / Q000235:genetics / Q000302:isolation & purification; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003236:Conjunctivitis, Viral / Q000175:diagnosis* / Q000821:virology; D004279:DNA, Viral / Q000032:analysis; D003941:Diagnostic Techniques, Ophthalmological; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D019095:Point-of-Care Systems / Q000592:standards*; D016133:Polymerase Chain Reaction / Q000379:methods; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D004279:DNA, Viral
keywords: Conjunctiva; Diagnostic tests/Investigation; Infection