HIQA publishes a rapid health technology assessment on Covid-19 diagnostic testing

HIQA has published a rapid health technology assessment (HTA) of alternative diagnostic testing methods for detecting Covid-19, as requested by the National Public Health Emergency Team (NPHET).

Dr Máirín Ryan, HIQA’s Deputy CEO and Director of Health Technology Assessment, said: “The World Health Organisation (WHO) has identified that testing for Covid-19 is critical to tracking the viral spread, understanding the epidemiology of the disease, informing case management and reducing transmission. To ensure that Ireland is ready to make the best use of emerging developments in this area, we assessed the available evidence for the alternative diagnostic tests, whether any of these tests are being used internationally, and when the tests could be deployed in the clinical pathway.”

The assessment identified a wide range of diagnostic tests, both in development and already commercialised. However, before these tests can be adopted as part of a national testing strategy, they will need to be independently clinically validated, locally verified, with ongoing review as part of a comprehensive quality assurance programme. The current test, real-time RT-PCR*, remains the ‘gold standard’ test for detecting and confirming COVID-19 cases.

Dr Ryan continued: “Real-time RT-PCR is the most clinically-effective test available. Efforts are currently underway to improve turnaround times for analysis, which will expand testing capacity and allow the labs to respond to the demand for increased testing. Other tests under development, including rapid antigen tests and rapid antibody tests, must be proven to be safe and effective before they can be used in clinical decision-making to ensure that both physicians and patients have confidence in the test results.

“To this end, a cohesive national testing strategy is needed to ensure the right test is undertaken in the right person, at the right time and for the right purpose. This will enable appropriate governance of Covid-19 testing, including clear criteria for the administration and reporting of tests.

“This assessment will inform NPHET’s decision-making to ensure that Ireland is ready to move to new or improved testing methods when they become available.”

HIQA will continue to monitor and assess the evidence on alternative diagnostic testing approaches for Covid-19 as it emerges and will participate in a European joint rapid HTA on testing.