Jon Deeks FMedSci Profile picture
Apr 9, 2021 11 tweets 4 min read Read on X
Take note - @dhscgov rapid tests are being sent out (certainly in schools) with two different (and conflicting) information sheets, one in the box and one given out separately.

(the crumpled one with the picture is in the box, the glossy one is handed out separately).

1/10
The clue to which one is most up to date is on the back page (the one in the box is the out of date version).

2/10
The important difference in on page 2, which has far more info in the box (1st) version than the version given out about who should use the test and what they should do.

3/10
The box version states "You can use this self-test kit if you have symptoms or if your are asymptomatic (you do not have symptoms)"

There is no equivalent statement in the new guidance. (it states on p3 that you should refer to NHS guidance online if you have symptoms).

4/10
The "what your results mean" section has moved to page 16 in the new booklet

5/10
The original version (in the box) gives no clear directions on what the results mean and what you should do. There is no instruction to isolate with a positive result or to maintain social distancing with a negative result.

It really did need changing.
6/10
The new version is much clearer - "should" has been changed to "must" for both positive (isolate) and negative (continue social distancing etc).

7/10
But giving everybody two different leaflets is clearly going to cause massive confusion. And there seems little doubt that "the one on the box" is the one people will be able to find most easily.

8/10
@MHRAgovuk is this acceptable to distribute a test providing a outdated instructions for use document? We would never allow this for a drug.

9/10
For added confusion the boxes also contain this note from Xiamen saying that they are for use in "individuals who are suspected of COVID-19 by their healthcare provider".

10/10

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More from @deeksj

Jul 23, 2021
Daily Testing in school study report is out but presentation by BBC here is SPIN SPIN SPIN

The trial failed to show convincing reductions in school absence, and could not rule out large increases in Covid transmission. Sensitivity of the test was 53%.

bbc.co.uk/news/health-57…
The preprint for this study is here. Not yet peer reviewed.

modmedmicro.nsms.ox.ac.uk/wp-content/upl…
BBC says that reduced absence by 33%, but the ITT analysis in the text says 20% reduction with 95% confidence interval from 46% reduction to a 19% increases (p=0.27). So no convincing evidence of a reduction.
Read 12 tweets
Jul 18, 2021
SO what’s this POSITIVE news about medical tests?

Said it would be Monday, but actually the news broke this afternoon. So an early release from my tease …

Thanks for sharing your hopes about what it might be … I enjoyed many of them … but none were that close.

1/10
For me, positive news would be knowing

1) High quality tests are developed using the best expertise from industry and universities

2)Tests are evaluated in strong robust studies to work out whether they work in the real world for the purposes to which they are put

2/10
3) Study findings report the truth about whether they do more good than harm, and not spun for profit, popularity or reputation

4) Tests are developed to meet the greatest public health needs

5) Tests are affordable and available in the populations that need them most

3/10
Read 11 tweets
Jul 15, 2021
This new study suggests LFTs in primary care have sensitivity of 95% and specificity of 89%, but it is FLAWED.

These results are misleading because of PARTIAL VERIFICATION BIAS

A quick lesson ….

1/9
sciencedirect.com/science/articl…
Participants were first tested with LFTs – 810 positive and 1736 negative. The investigators choose to test 217 of the 1736 negatives with PCR – that’s 1 in 8. This wasn’t a random sample as they were influenced by clinical characteristics as well as the test result.

2/9
The sensitivity / specificity calculation is based on all LFT+ves and 12.5% of LFT-ves as follows:

3/9
Read 9 tweets
Jul 7, 2021
Even more data on LFTs out today.

@dhscgovuk released report of studies of Innova and Orient Gene, and their interpretation of findings.

Includes unpublished studies

BUT Clear evidence of post hoc interpretation of results based on naïve definition of infectiousness.

1/10
Long link is here:

gov.uk/government/pub…

2/10
@dhscgov define

HIGH viral load as >1,000,000 RNA/ml and appear to consider that these are the only cases which matter.

10,000 to 1,000,000 is LOW (not moderate)

<10,000 MINIMAL.

This is despite acknowledging there is no cut-off that categorises people as infectious

3/10
Read 11 tweets
Jun 22, 2021
Results from the LIVERPOOL EVENT PILOTS have been published on line and in the media. Somehow I missed these coming out. cultureliverpool.co.uk/event-research…

No official report from @dhscgov as per normal.
Seems important evidence is being delayed once again.

1/7
The bottom line is that the events were safe.

Kudos to Liverpool PH Team.

But detail is interesting to see why they were safe.

2/7
First the infection rate in Liverpool was very low when the events were held

Negative LFTs required for entry. 5/13263 positive and excluded. Same-day PCR found 4 people positive who had attended with false negative LFTs. So 5/9 were picked up by LFT – 44% missed.

3/7
Read 7 tweets
Jun 17, 2021
What do we known about ORIENT GENE used in the Daily Contact Testing Trial by the @educationgovuk and @DHSCgovuk?

There have been claims that this test is as good as others and has been reviewed by @MHRAgovuk for use in assisted testing. This is not right

1/10
The process does not make sense.

The MHRA never review products for assisted testing as they are professional use tests, which go through the self-certification process to get a CE-IVD mark.
MHRA doesn't go near this process.

2/n
In fact ORIENT GENE is not even on the MHRA register of products which is a requirement. You can check here - both for the product and manufacturer (sorry for the messy link).

3/n

aic.mhra.gov.uk/era/pdr.nsf/na…
Read 11 tweets

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