{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T04:31:51Z","timestamp":1791952311459,"version":"4.3.4"},"reference-count":50,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2023,1,20]],"date-time":"2023-01-20T00:00:00Z","timestamp":1674172800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004319","name":"Pfizer Inc","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,7,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Most observational population-based studies identify respiratory syncytial virus (RSV) by nasal\/nasopharyngeal swab reverse transcriptase real-time PCR (RT-PCR) only. We conducted a systematic review and meta-analyses to quantify specimen and diagnostic testing-based underascertainment of adult RSV infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>EMBASE, PubMed, and Web of Science were searched (January 2000\u2212December 2021) for studies including adults using\/comparing &amp;gt;1 RSV testing approach. We quantified test performance and RSV detection increase associated with using multiple specimen types.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 8066 references identified, 154 met inclusion. Compared to RT-PCR, other methods were less sensitive: rapid antigen detection test (RADT; pooled sensitivity, 64%), direct fluorescent antibody (DFA; 83%), and viral culture (86%). Compared to singleplex PCR, multiplex PCR's sensitivity was lower (93%). Compared to nasal\/nasopharyngeal swab RT-PCR alone, adding another specimen type increased detection: sputum RT-PCR, 52%; 4-fold rise in paired serology, 44%; and oropharyngeal swab RT-PCR, 28%. Sensitivity was lower in estimates limited to only adults (for RADT, DFA, and viral culture), and detection rate increases were largely comparable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>RT-PCR, particularly singleplex testing, is the most sensitive RSV diagnostic test in adults. Adding additional specimen types to nasopharyngeal swab RT-PCR testing increased RSV detection. Synergistic effects of using \u22653 specimen types should be assessed, as this approach may improve the accuracy of adult RSV burden estimates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/infdis\/jiad012","type":"journal-article","created":{"date-parts":[[2023,1,20]],"date-time":"2023-01-20T06:59:45Z","timestamp":1674197985000},"page":"173-184","source":"Crossref","is-referenced-by-count":210,"title":["Underascertainment of Respiratory Syncytial Virus Infection in Adults Due to Diagnostic Testing Limitations: A Systematic Literature Review and Meta-analysis"],"prefix":"10.1093","volume":"228","author":[{"given":"Chukwuemeka","family":"Onwuchekwa","sequence":"first","affiliation":[{"name":"P95 Epidemiology and Pharmacovigilance , Leuven , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura Mora","family":"Moreo","sequence":"additional","affiliation":[{"name":"P95 Epidemiology and Pharmacovigilance , Leuven , 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