Is there any role for rapid tests for Chlamydia trachomatis?

The main aim of this pilot study was to evaluate the sensitivity and specificity of a recently introduced rapid diagnostic test, the QuickVue chlamydia test against polymerase chain reaction (PCR) for endocervical samples. Due to concerns surrounding the low specificity of rapid tests for a low prevalence population we assessed its performance for both high and low prevalence populations. The sensitivity and specificity of the QuickVue test compared to PCR were 65% (95% confidence interval CI] 42-87%) and 100% respectively for the high prevalence population and 25% (95% CI: 5-70%) and 100% respectively for the low prevalence population. The positive predictive value (PPV) was 100% for both high and low prevalence population. The sensitivity of the QuickVue test for a high prevalence population was comparable to laboratory-based immunoassay techniques. However, for a low prevalence population, this test did not identify one in 4 cases due to its low sensitivity and its use cannot be recommended. Although the high specificity and PPV of this test indicate that for positive results no confirmatory test would be needed, because of the small number of cases included in this pilot study, this finding needs to be explored through a larger study.