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Inicio Medicina Clínica (English Edition) COVID-19 diagnostic tests: Importance of the clinical context
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Vol. 157. Issue 4.
Pages 185-190 (August 2021)
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Vol. 157. Issue 4.
Pages 185-190 (August 2021)
Review
COVID-19 diagnostic tests: Importance of the clinical context
Pruebas diagnósticas COVID-19: importancia del contexto clínico
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Marc Vila Muntadasa,
Corresponding author
marcvilamuntadas@gmail.com

Corresponding author.
, Inés Agustí Sunyerb, Alvar Agustí Garcia-Navarrob,c,d
a Equip d’Atenció Primària Vic (EAPVIC), Vic, Barcelona, Spain
b Hospital Clínic de Barcelona, Barcelona, Spain
c Universidad de Barcelona (UB), Barcelona, Spain
d CIBER Enfermedades Respiratorias, Madrid, Spain
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Table 1. Influence of COVID-19 prevalence on the diagnostic performance of a test having a sensitivity of 70% and a specificity of 95%.53
Abstract

The current SARS-CoV-2 pandemic poses numerous health challenges, including the adequate use and proper interpretation of the different available tests in different clinical settings. As any diagnostic test, those of SARS-CoV-2 have methodological limitations of sensitivity (S) and specificity (E), which eventually determine their positive (PPV) and negative (NPV) predictive value. Furthermore, their diagnostic performance depends on the clinical context in which these tests are used, that is, on the pretest probability. This article: (1) reviews the main methodological aspects that influence the S, E, PPV and NPV of the most common SARS-CoV-2 diagnostic tests; and, (2) discusses its diagnostic interpretation in different clinical settings.

Keywords:
Coronavirus
Diagnosis
Transmission
Clinical picture
Prevention
SARS-CoV-2
Resumen

La actual pandemia de SARS-CoV-2 plantea numerosos retos sanitarios, entre los que destaca el uso adecuado e interpretación correcta de las pruebas diagnósticas disponibles en diferentes contextos clínicos. Como cualquier prueba diagnóstica, las de SARS-CoV-2 tienen limitaciones metodológicas de sensibilidad (S) y especificidad (E) que determinan su valor predictivo positivo (VPP) y negativo (VPN). Además, su rendimiento diagnóstico depende del contexto clínico en el que se evalúen, es decir de la probabilidad pretest. Este artículo revisa los principales aspectos metodológicos que influyen sobre la S, E, VPP y VPN de las pruebas diagnósticas de SARS-CoV-2 más habituales y discute su interpretación diagnóstica en diferentes escenarios clínicos.

Palabras clave:
Coronavirus
Diagnóstico
Transmisión
Cuadro clínico
Prevención
SARS-CoV-2

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