HIQA was asked by the National Public Health Emergency Team to undertake a rapid health technology assessment (HTA) of the alternatives to laboratory-based real-time reverse-transcription polymerase chain reaction (rRT-PCR) to diagnose current infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
Internationally, rRT-PCR is considered the gold standard test for the detection of SARS-CoV-2. However, prolonged turnaround times resulting from sample transportation to centralised laboratories and sample processing requirements can preclude clinical utility, particularly during periods of widespread community transmission, in terms of clinical management of cases and initation of public health interventions including rapid isolation of infected individuals and tracing close contacts.
A broad range of alternative tests and testing strategies could be used to expand test capacity, reduce test turnaround times and improve access to testing. HIQA considered a wide range of alternative tests and testing strategies, investigated the extent that alternatives to rRT-PCR are in use or recommended for use internationally; summarised the diagnostic accuracy of available alternatives to rRT-PCR; and addressed the potential organisational considerations and resource implications that might arise from the use of alternative tests to support current laboratory-based rRT-PCR as part of the national COVID-19 testing strategy in Ireland.