Diagnostic accuracy of the Quidel Sofia rapid influenza fluorescent immunoassay in patients with influenza-like illness: A systematic review and meta-analysis

• Published in: Tuberculosis and respiratory diseases Vol. 84; no. 3; pp. 226 - 236
• Main Authors: Lee, Jonghoo, Song, Jae-Uk, Kim, Yee Hyung
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Academy of Tuberculosis and Respiratory Diseases 01.07.2021; 대한결핵및호흡기학회
• Subjects: diagnosis; fluorescence polarization immunoassay; human; influenza; Original; point-of-care testing; 내과학; Fluorescence Polarization Immunoassay; Diagnosis; Point-of-Care Testing; Influenza, Human
• ISSN: 1738-3536; 2005-6184
• DOI: 10.4046/trd.2021.0033

Although the Quidel Sofia rapid influenza fluorescent immunoassay (FIA) is widely used to identify influenza A and B, the diagnostic accuracy of this test remains unclear. We compared the diagnostic performances of this test with reverse transcriptase-polymerase chain reaction. A systematic literature search was performed using MEDLINE, EMBASE, and the Cochrane Central Register. The sensitivity, specificity, diagnostic odds ratio (DOR), and a hierarchical summary receiver-operating characteristic curve (HSROC) of this test for identifying influenza A and B were pooled using meta-analysis. A sensitivity and subgroup analysis was used to identify potential sources of heterogeneity within the selected studies. We identified seventeen studies comprising 8,334 patients. The pooled sensitivity, specificity, and DOR of the Quidel Sofia rapid influenza FIA to identify influenza A were 0.78 (95% CI, 0.71-0.83), 0.99 (95% CI, 0.98-0.99), and 251.26 (95% CI, 139.39-452.89), respectively. The pooled sensitivity, specificity, and diagnostic odds ratio of this test to identify influenza B were 0.72 (95% CI, 0.60-0.82), 0.98 (95% CI, 0.96-0.99), and 140.20 (95% CI, 55.92-351.54), respectively. The area under the HSROC for this test was similar for identification of influenza A and influenza B. Age was considered a probable source of heterogeneity. The pooled sensitivities of the Quidel Sofia rapid influenza FIA did not quite meet the target level (≥80%) for both influenza A and B. The interpretation of data should be carefully considered due to substantial between-study heterogeneity.