Self-collected Compared With Professional-Collected Swabbing in the Diagnosis of Influenza in Symptomatic Individuals: A Meta-Analysis and Assessment of Validity

J Clin Virol. 2019 Sep;118:28-35. doi: 10.1016/j.jcv.2019.07.010. Epub 2019 Aug 2.

Abstract

Self-collected nasal swabs offer a cheaper alternative to professional-collected swabs for influenza testing. However, the diagnostic accuracy of self-collection has not been quantitatively reviewed. We identified 14 studies that compared diagnostic accuracy of self-collected to professional-collected swabs in influenza symptomatic individuals. Self-collected swabs were found to be highly acceptable, simple and comfortable to use. Data from nine studies were meta-analyzed. Pooled sensitivity was 87% (95% CI: 80%, 92%) and specificity was 99% (95% CI: 98%, 100%), compared to professional-collected swabs in the diagnosis of influenza. Pooled sensitivity and specificity estimates were used to assess the potential bias that would be introduced in studies had self-collected rather than professional-collected samples been used. While self-collected swabbing should not replace the role of clinical testing, our findings support the use of self-collected swabs for influenza research and surveillance. This method will be an important tool for evaluating novel influenza vaccines and vaccination strategies.

Keywords: Diagnostic accuracy; Influenza; Nasal swabbing; Self-swabbing; Systematic review.

Publication types

  • Comparative Study
  • Evaluation Study
  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Diagnostic Tests, Routine / methods*
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Influenza, Human / diagnosis*
  • Male
  • Middle Aged
  • Nasal Cavity / virology*
  • Orthomyxoviridae / isolation & purification*
  • Self-Examination / methods*
  • Sensitivity and Specificity
  • Specimen Handling / methods*
  • Young Adult