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A new test, Direct RT-LAMP KIT is being piloted in Liverpool hospitals. There has been an article which has received a lot of attention.
I think the way the data is presented in this article is perhaps misleading, or has misunderstood the purpose of the test.
A thread
1/ https://twitter.com/guardian/status/1324420927199825920
I think the way the data is presented in this article is perhaps misleading, or has misunderstood the purpose of the test.
A thread
1/ https://twitter.com/guardian/status/1324420927199825920
The new test is intended for use in combination with regular PCR screening in vulnerable settings (such as hospitals).
Direct LAMP is pretty easy to use & can give results in about 10 minutes. But its lower sensitivity means it will only accurately detect very strong positives.
Direct LAMP is pretty easy to use & can give results in about 10 minutes. But its lower sensitivity means it will only accurately detect very strong positives.
But, statistically, these are the most infectious people, and so the most urgent to find quickly.
The trick, and what the article and MTEG seem to have missed, is that all the negatives from Direct-LAMP then go through standard through PCR screening.
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The trick, and what the article and MTEG seem to have missed, is that all the negatives from Direct-LAMP then go through standard through PCR screening.
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So the overall sensitivity and specificity of the whole system actually increases (very very slightly).
I does add steps to workflow though and so would need to come with an increase in resources.
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I does add steps to workflow though and so would need to come with an increase in resources.
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So the Direct-LAMP test works as part of a screening system, as per the instruction manual, and could be beneficial as hospital PCR turnaround times can be 24-48h, whereas this takes 10 mins to find the most infectious cases. All weaker positives would then b found w normal PCR.
Imho, I think if there are sufficient staffing levels and everyone is clear on how it works, there is potential these tests can be useful for screening in vulnerable settings, especially if PCR turnaround time is > 24 hours.
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But, and this is important, I do not see a real benefit of using these tests over rapid antigen tests in the same way (although it may mitigate some supply chain issues).
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Because I'm now going against the tide in backing DHSC, which I hate to do lol, some balance.
It may well be that some conflicts of interest are why this test is being pursued, when rapid antigen tests could perform the same function (possibly better). https://twitter.com/DHSCgovuk/status/1324432641685413888?s=19
It may well be that some conflicts of interest are why this test is being pursued, when rapid antigen tests could perform the same function (possibly better). https://twitter.com/DHSCgovuk/status/1324432641685413888?s=19
But choosing these alternative tests could mitigate supply chain issues. Let's hope it's that.
And whilst were here, @DHSCgovuk, would very much appreciate if you could publish all validation & pilot data of the new tests, it may help resolve a lot of the distrust in new tests.
And whilst were here, @DHSCgovuk, would very much appreciate if you could publish all validation & pilot data of the new tests, it may help resolve a lot of the distrust in new tests.
Fyi we don't know for sure that they are using PCR in tandem.
I honestly can't quite believe that they would be stupid enough to not do this though, especially in a hospital setting, and for a pilot.
If they're really not though then I guess there is a serious scandal there.
I honestly can't quite believe that they would be stupid enough to not do this though, especially in a hospital setting, and for a pilot.
If they're really not though then I guess there is a serious scandal there.
