Can we climb out of the 'pit' of poorly performing rapid diagnostic tests for chlamydia?

Michel et al (see page 187) present documentation in this issue that a Conformitee Europeenne (CE) marked home-use test for Chlamydia trachomatis that is available over the internet performs very poorly.1 The authors demonstrated a lack of accuracy of this assay compared with Amplicor PCR with sensitivities of 12.5% and 20% in both a lower (8% prevalence) and high prevalence (22.9% prevalence) population, respectively. False-positive results were equally as problematic, since the specificities were only 93.5% and 88.1% in the two populations studied. Since this test could be used by asymptomatic women, taking advantage of easy purchasing through the internet, the demonstrated positive predictive value of 28% is also unacceptable. With …