Use of SARS-CoV-2 antigen-detection rapid diagnostic tests for COVID-19 self-testing: interim guidance, 9 March 2022: web annex E: evidence to decision making table: should COVID-19 self-testing, using Ag-RDTs, be offered as an additional testing approach?
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World Health Organization
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[12] p.
This web annex presents the evidence-to-decision (EtD) framework developed according to the GRADE methodology to support the WHO recommendation on offering COVID-19 self-testing using SARS-CoV-2 antigen-detection rapid diagnostic tests (Ag-RDTs) as an additional approach to national testing services. It systematically evaluates the available evidence across key decision-making domains, including the priority of the public health problem, desirable and undesirable effects, certainty of the evidence, values and preferences, balance of effects, resource requirements, cost-effectiveness, equity, acceptability and feasibility. Drawing on systematic reviews together with complementary evidence from feasibility studies, values and preferences research and global policy surveys, the framework provides the rationale underpinning the recommendation in a transparent and structured manner. Overall, the assessment concludes that the anticipated benefits of COVID-19 self-testing outweigh its potential harms and supports a strong recommendation for offering self-testing as an additional testing option. The evidence indicates that self-testing is acceptable, feasible and likely to improve equitable access to testing while complementing professionally administered services. Although evidence on resource use and cost-effectiveness remains limited and context dependent, implementation is supported through considerations on human rights, epidemiological context, programme delivery, monitoring, surveillance and research priorities to guide countries in adapting COVID-19 self-testing strategies to evolving national needs.
This web annex presents the evidence-to-decision (EtD) framework developed according to the GRADE methodology to support the WHO recommendation on offering COVID-19 self-testing using SARS-CoV-2 antigen-detection rapid diagnostic tests (Ag-RDTs) as an additional approach to national testing services. It systematically evaluates the available evidence across key decision-making domains, including the priority of the public health problem, desirable and undesirable effects, certainty of the evidence, values and preferences, balance of effects, resource requirements, cost-effectiveness, equity, acceptability and feasibility. Drawing on systematic reviews together with complementary evidence from feasibility studies, values and preferences research and global policy surveys, the framework provides the rationale underpinning the recommendation in a transparent and structured manner. Overall, the assessment concludes that the anticipated benefits of COVID-19 self-testing outweigh its potential harms and supports a strong recommendation for offering self-testing as an additional testing option. The evidence indicates that self-testing is acceptable, feasible and likely to improve equitable access to testing while complementing professionally administered services. Although evidence on resource use and cost-effectiveness remains limited and context dependent, implementation is supported through considerations on human rights, epidemiological context, programme delivery, monitoring, surveillance and research priorities to guide countries in adapting COVID-19 self-testing strategies to evolving national needs.