Review ArticleAccuracy of Rapid Point-of-Care Diagnostic Tests for Hepatitis B Surface Antigen—A Systematic Review and Meta-analysis
Section snippets
Protocol
We sought to conduct a systematic review and meta-analysis on studies which evaluated accuracy of RPOCTs for HBsAg. A protocol was written that specified several aspects of the meta-analysis (available at our website www.drkhuroo.com; Appendix Document 1) as per PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analysis) guidelines.20 Two independent reviewers made literature search, performed quality assessment of the included studies and extracted data for estimating test
Literature Search
We identified 29 articles eligible for inclusion (Figure 1).11, 12, 13, 15, 16, 17, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51 Data from 2 studies had duplicate publications. Official report of International Consortium for Blood Safety 2007 (ICBS,12) was published as a full-text paper in a peer-reviewed journal.47 Sera from another study were collected and tested in Malawi44 and had shown conflicting results. The same sera were retested in UK and
Discussion
The present meta-analysis had six strengths when compared to 2 earlier studies10, 52: i) global and complete literature search, with strict inclusion criteria, ii) defined strategy to include and analyze inconclusive results, iii) use of Bivariate statistical model, iv) statistical comparison in meta-regression model of summary estimates of diagnostic accuracy within subgroups to make relevant conclusions, v) evaluation of heterogeneity and its potential sources in the meta-regression model,
Conclusions
RPOCTs have major benefits to offer in screening and control of HBV infection especially in far flung low resource endemic zones of the world. The tests are cheap, give rapid diagnosis, are convenient and easy to store, need small blood samples for testing, need minimal training of professionals for testing and need no or minimal expensive equipment. However, their global uptake needs to be addressed keeping in view the overall performance of the tests. With present low level of test accuracy
Funding source
Our study was funded by the “Dr. Khuroo's Medical Trust”, a non-profit organization to promote research and help poor patients for medical treatment. The funding source had no role in the conception, design or conduct of this review.
Conflicts of interest
All authors have none to declare.
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