Exploring beyond the limit: How comparative stochastic performance affects retesting outcomes in six commercial SARS CoV-2 nucleic acid amplification tests

Chan, Hiu Tat and Keung, Marco H.T. and Nguyen, Ivy and Ip, Ellen L.O. and Chew, Su M. and Siler, Danielle and Saville, Marion and Hawkes, David (2022) Exploring beyond the limit: How comparative stochastic performance affects retesting outcomes in six commercial SARS CoV-2 nucleic acid amplification tests. Journal of Clinical Virology Plus, 2 (3). ISSN 2667-0380, DOI https://doi.org/10.1016/j.jcvp.2022.100079.

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Abstract

Objectives: To examine the comparative stochasticity profile of six commercial SARS-CoV-2 nucleic acid amplification tests (NAATs) and how this may affect retesting paradigms. Methods: Commercial quality control (QC) material was serially diluted in viral transport media to create a panel covering 10–10,000 copies/ml. The panel was tested across six commercial NAATs. A subset of high cycle threshold results was retested on a rapid PCR assay to simulate retesting protocols commonly used to discriminate false positives. Results: Performance beyond the LOD differed among assays, with three types of stochasticity profiles observed. The ability of the rapid PCR assay to reproduce a true weak positive specimen was restricted to its own stochastic performance at the corresponding viral concentration. Conclusion: Stochastic performance of various NAATs overlap across low viral concentrations and affect retesting outcomes. Relying on retesting alone to discriminate false positives risk missing true positives even when a more sensitive assay is deployed for confirmatory testing. © 2022 The Author(s)

Item Type: Article
Funders: UNSPECIFIED
Uncontrolled Keywords: Comparative sensitivity; False negative; False positive; Limit of detection; Nucleic acid amplification tests; SARS-CoV-2; Stochastic performance
Subjects: R Medicine > RB Pathology
R Medicine > RG Gynecology and obstetrics
Divisions: Faculty of Medicine > Obstetrics & Gynaecology Department
Faculty of Medicine > Pathology Department
Depositing User: Ms. Juhaida Abd Rahim
Date Deposited: 30 May 2025 01:26
Last Modified: 30 May 2025 01:26
URI: http://eprints.um.edu.my/id/eprint/43396

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