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New Abbott SARS-CoV-2 antibody test has 99.90% specificity and 100% sensitivity

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Re: New Abbott SARS-CoV-2 antibody test has 99.90% specificity and 100% sensitivity

#6
There seems to be no analysis of whether these are neutralizing antibodies. The idea of using serology for immunity certificates or "golden tickets" is never going to go well. Even with 99.9% specificity, if the population prevalence is 1%, 10% of positives will be false positives. If in real world testing, specificity is 99% and population prevalence is 1%, then 50% of positives are false positives.

Re: New Abbott SARS-CoV-2 antibody test has 99.90% specificity and 100% sensitivity

#7
post #6

There seems to be no analysis of whether these are neutralizing antibodies. The idea of using serology for immunity certificates or "golden tickets" is never going to go well. Even with 99.9% specificity, if the population prevalence is 1%, 10% of positives will be false positives. If in real world testing, specificity is 99% and population prevalence is 1%, then 50% of positives are false positives.

Would you or someone else mind expanding on this thought a little? Why does 99.9% specificity mean that 10% will be false positives?

{added: great answers below} well worth understanding this point. In short specificity measures the % of the population tested which had false positives, but doesn't give you the ratio of false positives to positives or the probability that a positive test means you actually have the anti-bodies.

Re: New Abbott SARS-CoV-2 antibody test has 99.90% specificity and 100% sensitivity

#8
post #6

There seems to be no analysis of whether these are neutralizing antibodies. The idea of using serology for immunity certificates or "golden tickets" is never going to go well. Even with 99.9% specificity, if the population prevalence is 1%, 10% of positives will be false positives. If in real world testing, specificity is 99% and population prevalence is 1%, then 50% of positives are false positives.

If we want to ensure that the active population is always above herd immunity threshold, 10% or 20% false positives would be acceptable, since the population in contact would still be 80 or 90% immune.

Re: New Abbott SARS-CoV-2 antibody test has 99.90% specificity and 100% sensitivity

#10
post #6

There seems to be no analysis of whether these are neutralizing antibodies. The idea of using serology for immunity certificates or "golden tickets" is never going to go well. Even with 99.9% specificity, if the population prevalence is 1%, 10% of positives will be false positives. If in real world testing, specificity is 99% and population prevalence is 1%, then 50% of positives are false positives.

What's wrong with 10% of them being false positives? (also I think it's 9%)
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