Recommendations for SARS-CoV-2/COVID-19 testing: a scoping review of current guidance.

Arevalo-Rodriguez, Ingrid; Seron, Pamela; Buitrago-García, Diana; Ciapponi, Agustin; Muriel, Alfonso; Zambrano-Achig, Paula; Del Campo, Rosa; Galán-Montemayor, Juan Carlos; Simancas-Racines, Daniel; Perez-Molina, Jose A; Khan, Khalid Saeed; Zamora, Javier (2021). Recommendations for SARS-CoV-2/COVID-19 testing: a scoping review of current guidance. BMJ open, 11(1), e043004. BMJ Publishing Group 10.1136/bmjopen-2020-043004

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BACKGROUND

Testing used in screening, diagnosis and follow-up of COVID-19 has been a subject of debate. Several organisations have developed formal advice about testing for COVID-19 to assist in the control of the disease. We collated, delineated and appraised current worldwide recommendations about the role and applications of tests to control SARS-CoV-2/COVID-19.

METHODS

We searched for documents providing recommendations for COVID-19 testing in PubMed, EMBASE, LILACS, the Coronavirus Open Access Project living evidence database and relevant websites such as TRIP database, ECRI Guidelines Trust, the GIN database, from inception to 21 September 2020. Two reviewers applied the eligibility criteria to potentially relevant citations without language or geographical restrictions. We extracted data in duplicate, including assessment of methodological quality using the Appraisal of Guidelines for Research and Evaluation-II tool.

RESULTS

We included 47 relevant documents and 327 recommendations about testing. Regarding the quality of the documents, we found that the domains with the lowest scores were 'Editorial independence' (Median=4%) and 'Applicability' (Median=6%). Only six documents obtained at least 50% score for the 'Rigour of development' domain. An important number of recommendations focused on the diagnosis of suspected cases (48%) and deisolation measures (11%). The most frequently recommended test was the reverse transcription-PCR (RT-PCR) assay (87 recommendations) and the chest CT (38 recommendations). There were 22 areas of agreement among guidance developers, including the use of RT-PCR for SARS-Cov-2 confirmation, the limited role of bronchoscopy, the use chest CT and chest X-rays for grading severity and the co-assessment for other respiratory pathogens.

CONCLUSION

This first scoping review of recommendations for COVID-19 testing showed many limitations in the methodological quality of included guidance documents that could affect the confidence of clinicians in their implementation. Future guidance documents should incorporate a minimum set of key methodological characteristics to enhance their applicability for decision making.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

Graduate School:

Graduate School for Health Sciences (GHS)

UniBE Contributor:

Buitrago Garcia, Diana Carolina

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

2044-6055

Publisher:

BMJ Publishing Group

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

14 Jan 2021 17:57

Last Modified:

14 Jan 2021 18:04

Publisher DOI:

10.1136/bmjopen-2020-043004

PubMed ID:

33408209

Uncontrolled Keywords:

diagnostic microbiology epidemiology protocols & guidelines

BORIS DOI:

10.48350/151324

URI:

https://boris.unibe.ch/id/eprint/151324

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