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首页> 外文期刊>Hepatology: Official Journal of the American Association for the Study of Liver Diseases >Impact of rapid point-of-care screening tests for the identification of chronic hepatitis C infection
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Impact of rapid point-of-care screening tests for the identification of chronic hepatitis C infection

机译：快速即时筛查对鉴定慢性丙型肝炎感染的影响

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Background: 170 million persons worldwide are infected with hepatitis C, many of whom are undiagnosed. Although rapid diagnostic tests (RDTs) and point-of-care tests (POCTs) provide a time- and cost-saving alternative to conventional laboratory tests, their global uptake partly depends on their performance. Purpose: To meta-analyze the diagnostic accuracy of POCTs and RDTs to screen for hepatitis C. Data Sources MEDLINE, EMBASE, BIOSIS, and Web of Science (1992 to 2012) and bibliographies of included articles. Study Selection: All studies evaluating the diagnostic accuracy of POCTs and RDTs for hepatitis C in adults (aged 18 years). Data Extraction: Two independent reviewers extracted data and critiqued study quality. Data Synthesis: Of 19 studies reviewed, 18 were meta-analyzed and stratified by specimen type (whole blood, serum, plasma, or oral fluid) or test type (POCT or RDT). Sensitivity was similarly high in POCTs of whole blood (98.9% [95% CI, 94.5% to 99.8%]) and serum or plasma (98.9% [CI, 96.8% to 99.6%]), followed by RDTs of serum or plasma (98.4% [CI, 88.9% to 99.8%]) and POCTs of oral fluid (97.1% [CI, 94.7% to 98.4%]). Specificity was also high in POCTs of whole blood (99.5% [CI, 97.5% to 99.9%]) and serum or plasma (99.7% [CI, 99.3% to 99.9%]), followed by RDTs of serum or plasma (98.6% [CI, 94.9% to 99.6%]) and POCTs of oral fluid (98.2% [CI, 92.2% to 99.6%]). Limitation:- Lack of data prevented sensitivity analyses of specific tests. Conclusion: Data suggest that POCTs of blood (serum, plasma, or whole blood) have the highest accuracy, followed by RDTs of serum or plasma and POCTs of oral fluids. Given their accuracy, convenience, and quick turnaround time, RDTs and POCTs may be useful in expanding first-line screening for hepatitis C. Primary Funding Source: Canadian Institutes of Health Research.
机译：背景：全球有1亿7千万人感染了丙型肝炎，其中许多人未被诊断。尽管快速诊断测试（RDT）和即时护理测试（POCT）提供了比传统实验室测试节省时间和成本的替代方法，但它们在全球的普及程度部分取决于其性能。目的：对POCT和RDT的诊断准确性进行荟萃分析，以筛查丙型肝炎。数据来源MEDLINE，EMBASE，BIOSIS和Web of Science（1992年至2012年）以及所包括文章的书目。研究选择：所有评估POCT和RDT对成人（18岁）丙型肝炎的诊断准确性的研究。数据提取：两名独立的审阅者提取数据并批评研究质量。数据综合：在所审查的19项研究中，对18项进行了荟萃分析并按样本类型（全血，血清，血浆或口腔液体）或测试类型（POCT或RDT）进行分层。全血POCTs（98.9％[95％CI，94.5％to 99.8％]）和血清或血浆（98.9％[CI，96.8％to 99.6％]），其次是血清或血浆的RDT，敏感性同样高。 98.4％[CI，88.9％至99.8％]）和POCT（97.1％[CI，94.7％至98.4％]）。全血POCT（99.5％[CI，97.5％至99.9％]）和血清或血浆（99.7％[CI，99.3％至99.9％]），其次是血清或血浆的RDT，特异性也很高。 [CI，94.9％至99.6％]）和口服液的POCT（98.2％[CI，92.2％至99.6％]）。局限性：-缺乏数据阻碍了特定测试的敏感性分析。结论：数据表明，血液（血清，血浆或全血）的POCT准确度最高，其次是血清或血浆的RDT和口服液的POCT。考虑到它们的准确性，便利性和快速的周转时间，RDT和POCT可能有助于扩大对丙型肝炎的一线筛查。主要资金来源：加拿大卫生研究院。

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