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Public's understanding of swab test results for SARS-CoV-2: an online behavioural experiment during the April 2020 lockdown.


ABSTRACT:

Objective

Although widespread testing for SARS-CoV-2 is in place, little is known about how well the public understands these results. We aimed to provide a comprehensive overview of the general public's grasp of the accuracy and significance of the results of the swab test.

Design

Web-based behavioural experiment.

Setting

Italy during the April 2020 lockdown.

Participants

566 Italian residents.

Main outcome measures

Participants' estimates of the SARS-CoV-2 prevalence; the predictive and diagnostic accuracy of the test; the behavioural impact of (positive vs negative) test results; the perceived usefulness of a short-term repetition of the test following positive or negative results; and rankings of causes for false positives and false negatives.

Results

Most participants considered the swab test useful (89.6%) and provided predictive values consistent with their estimates of test diagnostic accuracy and infection prevalence (67.0%). Participants acknowledged the effects of symptomatic status and geographical location on prevalence (all p<0.001) but failed to take this information into account when estimating the positive or negative predictive value. Overall, test specificity was underestimated (91.5%, 95% CI 90.2% to 92.8%); test sensitivity was overestimated (89.7%, 95% CI 88.3% to 91.0%). Positive results were evaluated as more informative than negative ones (91.6, 95% CI 90.2 to 93.1 and 41.0, 95% CI 37.9 to 44.0, respectively, p<0.001); a short-term repetition of the test was considered more useful after a positive than a negative result (62.7, 95% CI 59.6 to 65.7 and 47.2, 95% CI 44.4 to 50.0, respectively, p=0.013). Human error and technical characteristics were assessed as more likely to be the causes of false positives (p<0.001); the level of the viral load as the cause of false negatives (p<0.001).

Conclusions

While some aspects of the swab for SARS-CoV-2 are well grasped, others are not and may have a strong bearing on the general public's health and well-being. The obtained findings provide policymakers with a detailed picture that can guide the design and implementation of interventions for improving efficient communication with the general public as well as adherence to precautionary behaviour.

SUBMITTER: Pighin S 

PROVIDER: S-EPMC7813337 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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Publications

Public's understanding of swab test results for SARS-CoV-2: an online behavioural experiment during the April 2020 lockdown.

Pighin Stefania S   Tentori Katya K  

BMJ open 20210117 1


<h4>Objective</h4>Although widespread testing for SARS-CoV-2 is in place, little is known about how well the public understands these results. We aimed to provide a comprehensive overview of the general public's grasp of the accuracy and significance of the results of the swab test.<h4>Design</h4>Web-based behavioural experiment.<h4>Setting</h4>Italy during the April 2020 lockdown.<h4>Participants</h4>566 Italian residents.<h4>Main outcome measures</h4>Participants' estimates of the SARS-CoV-2 p  ...[more]

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