Self-collected compared with professional-collected swabbing in the diagnosis of influenza in symptomatic individuals: A meta-analysis and assessment of validity

Self-collected nasal swabs offer a cheaper alternative to professional-collected swabs for influenza testing. However, the diagnostic accuracy of self-collection has not been quantitatively reviewed. We identified 14 studies that compared diagnostic accuracy of self-collected to professional-collected swabs in influenza symptomatic individuals. Self-collected swabs were found to be highly acceptable, simple and comfortable to use. Data from nine studies were meta-analyzed. Pooled sensitivity was 87% (95% CI: 80%, 92%) and specificity was 99% (95% CI: 98%, 100%), compared to professional-collected swabs in the diagnosis of influenza. Pooled sensitivity and specificity estimates were used to assess the potential bias that would be introduced in studies had self-collected rather than professional-collected samples been used. While self-collected swabbing should not replace the role of clinical testing, our findings support the use of self-collected swabs for influenza research and surveillance. This method will be an important tool for evaluating novel influenza vaccines and vaccination strategies.