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Licensed Unlicensed Requires Authentication Published by De Gruyter October 2, 2014

Comparison of analytical sensitivity and women’s interpretation of home pregnancy tests

  • Sarah Johnson EMAIL logo , Michael Cushion , Sharon Bond , Sonya Godbert and Joanna Pike

Abstract

Background: Internationally there are no defined standards for expressing the performance of home-based pregnancy tests, nor any pre-defined accuracy standard requirements. The aim of this study was to evaluate the accuracy of a selection of home-based pregnancy tests relative to their packaging/product insert claims.

Methods: Eight home-based pregnancy tests were evaluated using human chorionic gonadotrophin (hCG) urine standards (0, 15, 25 mlU/mL). Testing was performed by a technician and results were read by a technician and a panel of consumer volunteers (each blinded to the expected result) and compared with the expected result based on the manufacturer’s claimed accuracy. Volunteers also completed questionnaires relating to various device attributes.

Results: The overall agreement between the technician reading and expected reading from the hCG concentration was >90% for the Clearblue® DIGITAL, Clearblue® PLUS, Confirme® Plus, David® and Haus™ tests, and approximately 80% for Predictor® Early; agreement was <50% for Femitest® Jet Ultra and Cyclotest® Early tests. Results were available from 72 volunteers (aged 18–45 years). Overall the percentage agreement between volunteer result and expected result was >95% for Clearblue DIGITAL and Clearblue PLUS tests; agreement for all other tests was <75% (lowest were Cyclotest Early and Femitest Jet Ultra, 33.0% and 39.4%, respectively). The Clearblue DIGITAL test was scored most highly by volunteers in the questionnaires.

Conclusions: Many home-based pregnancy tests commonly used by women are not as accurate as their packaging information claims. International test standards which define appropriate performance characteristics for home pregnancy tests are urgently required.


Corresponding author: Sarah Johnson, Clinical and Medical Affairs Manager, SPD Development Co., Ltd, Priory Business Park, Bedford, MK44 3UP, UK, Phone: +44 1234 835486, Fax: +44 1234 835006, E-mail:

Acknowledgments

Editorial assistance for the development of the manuscript was provided by Debra Scates of IMC Healthcare Communication, supported by SPD Development Co., Ltd.

Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Financial support: This study was funded by SPD Development Co., Ltd., a wholly owned subsidiary of SPD Swiss Precision Diagnostics GmbH, the makers of Clearblue™ products.

Employment or leadership: S. Johnson, M. Cushion, S. Bond, S. Godbert and J. Pike are all employees of SPD Development Co., Ltd.

Honorarium: None declared.

Competing interests: Study design; the collection, analysis, and interpretation of data; the writing of the report; and the decision to submit the report for publication were conducted by the authors, all of whom are employees of the funding organisation.

References

1. Scolaro KL, Braxton-Lloyd K, Helms KL. Devices for home evaluation of women’s health concerns. Am J Health-Syst Pharm 2008;65:299–314.10.2146/ajhp060565Search in Google Scholar

2. Afshar Y, Stanculescu A, Miele L, Fazleabas AT. The role of chorionic gonadotrophin and Notch 1 in implantation. J Assist Reprod Genet 2007;24:296–302.10.1007/s10815-007-9149-2Search in Google Scholar

3. Perrier d’Hauterive S, Charlet-Renard C, Dubois M, Foidart JM, Geenen V. What’s new at the maternal-foetal interface: role of the hCG/LH-hCG receptor couple during embryo implantation. Rev Med Liege 2006;61:705–12.Search in Google Scholar

4. Johnson SR, Miro F, Barrett S, Ellis JE. Levels of urinary human chorionic gonadotrophin (hCG) following conception and variability of menstrual cycle length in a cohort of women attempting to conceive. CMRO 2009;25:741–8.10.1185/03007990902743935Search in Google Scholar

5. Larsen J, Buchanan P, Johnson S, Godbert S, Zinaman M. Human chorionic gonadotropin as a measure of pregnancy duration. Int J Gyn Obst 2013;123:189–95.10.1016/j.ijgo.2013.05.028Search in Google Scholar

6. Gnoth C, Johnson S. Strips of hope: accuracy of home pregnancy tests and new developments. Geburtsh Frauenheilk 2014;74:661–9.10.1055/s-0034-1368589Search in Google Scholar

7. Johnson SR, Broomhead D, Tiplady S, Ellis J. Suitable performance of hCG and LH assays for use in urine samples. Clin Chem 2011;57(10 Suppl):A188.Search in Google Scholar

8. Jeng LL, Moore RM, Kaczmarek RG, Placek PJ, Bright RA. How frequently are home pregnancy tests used? Results from the 1988 National Maternal and Infant Health Survey. Birth 1991;18:11–3.10.1111/j.1523-536X.1991.tb00046.xSearch in Google Scholar

9. Tone A. Medicalizing reproduction: the pill and home pregnancy tests. J Sex Res 2012;49:319–27.10.1080/00224499.2012.688226Search in Google Scholar

10. Johnson SR, Godbert S, Roberts L, Parkinson P, Perry P. Consistent rise in urinary hCG in early pregnancy. Int J Gyn Obst 2012;119(Suppl 3):S543.10.1016/S0020-7292(12)61232-6Search in Google Scholar

11. Greene DN, Schmidt RL, Kamer SM, Grenache DG, Hoke C, Lorey TS. Limitations in qualitative point of care hCG tests for detecting early pregnancy. Clin Chim Acta 2013;415:317–21.10.1016/j.cca.2012.10.053Search in Google Scholar PubMed

12. Berger P, Sturgeon C. Human chorionic gonadotropin isoforms and their epitopes: diagnostic utility in pregnancy and cancer. Expert Opin Med Diagn 2008;2:1347–64.10.1517/17530050802558907Search in Google Scholar PubMed

13. Sturgeon CM, Berger P, Bidart J, Birken S, Burns C, Norman RJ, et al. Differences in recognition of the 1st WHO international reference reagents for hCG-related isoforms by diagnostic immunoassays for human chorionic gonadotropin. Clin Chem 2009;55:1484–91.10.1373/clinchem.2009.124578Search in Google Scholar PubMed

14. Cervinski MA, Lockwood CM, Ferguson AM, Odem RR, Stenman UH, Alfthan H, et al. Qualitative point-of-care and over-the-counter urine hCG devices differentially detect the hCG variants of early pregnancy. Clin Chim Acta 2009;406:81–5.10.1016/j.cca.2009.05.018Search in Google Scholar PubMed

15. Butler SA, Khanlian SA, Cole LA. Detection of early pregnancy forms of human chorionic gonadotrophin by home pregnancy test devices. Clin Chem 2001;47:2131–6.10.1093/clinchem/47.12.2131Search in Google Scholar

16. Johnson SR, Ellis J, Godbert S, Ali S, Zinaman M. Comparison of a digital ovulation test with three popular line ovulation tests to investigate user accuracy and certainty. Expert Opin Med Diagn 2011;5:467–73.10.1517/17530059.2011.617737Search in Google Scholar PubMed

17. Tomlinson C, Marshall J, Ellis JE. Comparison of accuracy and certainty of results of six home pregnancy tests available over-the-counter. Curr Med Res Opin 2008;24:1645–9.10.1185/03007990802120572Search in Google Scholar PubMed

18. Daiaud J, Fournet D, Ballongue C, Guillem G, Leblanc A, Casellas C, et al. Reliability and feasibility of pregnancy home-use tests: laboratory validation and diagnostic evaluation by 638 volunteers. Clin Chem 1993;39:53–9.10.1093/clinchem/39.1.53Search in Google Scholar

19. Wallace LS, Zite NB, Homewood VJ. Making sense of home pregnancy test instructions. J Women’s Health (Larchmt) 2009;18:363–8.10.1089/jwh.2008.0985Search in Google Scholar PubMed

20. Pike J, Godbert S, Johnson S. Comparison of volunteers’ experience of using, and accuracy of reading, different types of home pregnancy test formats. Expert Opin Med Diagn 2013;7:435–41.10.1517/17530059.2013.830103Search in Google Scholar PubMed

21. Nickmans S, Vermeersch P, Van Eldere J, Billen J. Performance of qualitative urinary hCG assays. Acta Clin Belg 2014;69:277–9.10.1179/0001551214Z.00000000069Search in Google Scholar PubMed


Supplemental Material

The online version of this article (DOI: 10.1515/cclm-2014-0643) offers supplementary material, available to authorized users.


Received: 2014-6-19
Accepted: 2014-8-25
Published Online: 2014-10-2
Published in Print: 2015-2-1

©2015 by De Gruyter

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