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Our conclusion was that the false positivity rates that clinicians were experiencing can be explained by the test specificity combined with the epidemiological changes of the rapidly decreasing HIV prevalence in babies undergoing routine testing as part of the PMTCT programme.
The following values were then calculated for each reference method used: agreement rate, test sensitivity, test specificity, positive predictive value, negative predictive value, and interval [kappa] for each participating laboratory.
High test specificity, the percentage of people without infection who test negative, is essential to avoid false-positive results and their consequences.
8% of patients with a diagnosis of heart failure, suggesting that the sensitivity of the test remains high, but BNP was also high in >28% of patients who did not carry a heart failure diagnosis, suggesting that test specificity was much lower than 76%-77%.
The lack of agreement among investigators and the low levels and low titers of H2 antibodies suggest either differences in test specificity, sensitivity, or both.