Jon Deeks Profile picture
10 Nov, 5 tweets, 2 min read
How well is the Innova test working in Liverpool?

This is a speculative calculation informed by data available from Liverpool. The source is the Liverpool mayor - reported 23,170 tests done, with 0.7% positive (so about 162) here.

liverpoolecho.co.uk/news/liverpool…
Presume specificity 99.6%

No sensitivity data for this test - @UKPHE has data but not public

I estimate sensitivity of 75% based on independent evaluations done for WHO of other similar LFIA tests (range from 50% to 90%) - but in symptomatic patients

finddx.org/covid-19/sarsc…
Using a prevalence of 400 per 100,000 you get the following 2x2 table:
11 of every 20 people told to isolate will not have Covid.

25 of every 100 people with Covid-19 will have negative results **** (I really hope they don’t now go and visit their granny)

One Covid case will have been found for every 330 tested.
**** Remember the sensitivity is a big guess – I’ve heard @PHE_uk have done studies in asymptomatic people- it is a scandal that they are not shared.

Real concern that Boris says we can use this for test-and-release – the -ve likelihood ratio is 0.25 - has Boris met Bayes?

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More from @deeksj

11 Nov
INNOVA test – time for critical appraisal of the report

What does the report say about the test and should we believe it?

1/20

ox.ac.uk/sites/files/ox…
There are a lot of data and studies reported - difficult to get your head round. Grateful to CI for talking to me this afternoon. He has worked at incredible speed to meet deadlines and says full report is forthcoming – there is more data and description to be added.

2/20
Phase 2 – spiked samples in controlled laboratory conditions

Phase 3a – samples from hospitals tested in controlled laboratory conditions

These do not tell us how well tests work in real world – important to do to move forward to what happens next, but pass by them now.

3/20
Read 20 tweets
1 Nov
How well will these 15-minute rapid tests Boris mentioned work? (quick answer – we don’t know)

The Innova test was mentioned this week in Telegraph.
telegraph.co.uk/news/2020/10/1…

and I presume was on Boris’s list of the tests last night.
We are updating our Cochrane review and have been through our searches. There are no pre-prints or published studies of this test.

There are 2 studies – 1 from the company Instructions for Use (IFU) and 1 from PHE Porton Down.

Test is made by Xiamen Biotime Biotech in China.
Quick Critical appraisal of PHE Porton Down study:
1)Is the study relevant? Can’t tell.
2)What do the results mean? Can’t tell.
3)Should we believe the results? Can’t tell.
(please give us the full report!!!)
Read 11 tweets
1 Nov
The PM claimed that they have validated these new 15min antigen tests – what is the @dhsc @phe validation process?

15 Aug ministers commissioned new process at PHE Porton Down in collaboration with Oxford University. Protocol here (updated 23 Oct).

gov.uk/government/pub…
3 phases:

1 document review

2A Test 60 spiked saliva samples (n=15x4 dilutions)+71 -ve samples

2B Test against seasonal coronaviruses

3 Lab study of 1000 negatives and 200 positives sourced by Oxford University Hospitals. -ves fresh (<48hr) saliva samples +ves frozen
“Phase 3 findings will be reported to the Oversight Group, with DHSC and ministers using this information and any recommendations to inform potential purchasing decisions.”

Little detail is public – full results below - criteria for “pass” and “fail” for Phase 3 not stated
Read 6 tweets
22 Sep
BMJ Editorial @bmj_latest on why Moonshot is scientifically unsound.

with Tony Brookes and @AllysonPollock

has just been published here

bmj.com/cgi/content/fu…

#Moonshot @UoB_IAHR @unibirm_MDS

1/10
Moonshot plans uses point of care tests (POCT) approved for home use which don’t yet exist.

Proposals use computer modelling not empirical evidence. Understanding model assumptions is critical.

Widely claimed model is based on using LESS ACCURATE TESTS. This is WRONG.

2/10
The model assumes new POCT is positive in people who have INFECTIOUS Covid-19

and negative in both those who don’t have COVID-19 infection at all

and negative in those who have NON-INFECTIOUS Covid-19.

(infectious means you can pass the virus to somebody else).

3/10
Read 10 tweets
18 Sep
What type of COVID-19 test do you think this is? @MHRAgovuk please have a look Image
Some antigens are proteins, so looks like if could be an antigen test, and a saliva one as well, and it is CE marked.

It's a dream ...
But it is actually an antibody test. Misleading?

(antibody tests have antigens (proteins) inside that detect the antibodies - so they are telling us what is inside it rather than what it detects).

Dream over.
Read 4 tweets
16 Sep
More iAbra statistical nonsense

Following from the Telegraph at the weekend, I have now seen the data from iAbra for their 20 second "Holographic microscopy" saliva test being trialled at Heathrow.

Start here in the FT, then see below.

1/10

ft.com/content/e7a279…
In FT I said:

“we are in a pandemic, people are dying from the disease, and a company decides that it is reasonable to mislead us all to make their test look like the best thing available."

2/10
"Legally, they can probably get away with this, but there cannot be any consideration that this is morally acceptable.”

They have said my characterisation was “incredibly unfair”.

See what you think.

3/10
Read 10 tweets

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