P-2173. Evaluation of Self/Parent Collected Oral/Nasal Swabs for Respiratory Illness in Symptomatic Children
Bibliographic record
Abstract
Abstract Background For children under the age of 4 who are unable to reliably gargle, a combined oral/nasal (ON) swab collected by the parent/caregiver may be offered, and is less invasive than the standard nasopharyngeal (NP) swab. We sought to determine the diagnostic yield and acceptability of self-collected ON swab samples compared to healthcare worker-collected NP swabs for respiratory viruses, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza, and respiratory syncytial virus (RSV) in children. Methods Symptomatic participants (0-4 years old) were recruited from a pediatric Emergency Department (ED) where they were undergoing clinical testing with an NP swab. Participants provided an additional ON swab using written self-collection instructions. Caregivers were asked to rate acceptability of ON and NP swab collections on a 5-point Likert scale. Both samples were collected with minitip flocked swabs and were tested with the SARS-CoV-2/Influenza A+B/RSV GeneXpert® assay. A portion of matched samples were also tested with the BioFire® RP2.1 respiratory panel. Results A total of 121 matched sample pairs were tested with the GeneXpert assay and had similar detection for RSV (28 ON positive vs 26 NP positive), influenza A (17 ON positive vs 17 NP positive), and SARS-CoV-2 (8 ON positive vs 10 NP positive). Median Ct values were higher for matched ON positives vs NP positives (26.2 vs 23.9). 58 pairs were also tested using the RP2.1 assay and showed a similar yield for total respiratory viruses detected (63 positive ON swabs vs 62 positive NP swabs). With either sample positive set as the reference for calculation of sensitivity, the ON and NP swab sensitivities are as follows: RSV (80.0% ON vs 100.0% NP), influenza A (94.4% ON vs 94.4% NP), SARS-CoV-2 (100.0% ON and 92.9% NP), and all other virus targets (82.6% ON vs 82.6% NP). Caregivers rated higher acceptability for ON swabs than HCW-collected NP swabs (median acceptability 2 vs 4). Conclusion The performance of self-collected ON swabs was similar to HCW-collected NP swabs for the detection of a range of respiratory viruses across two commercial molecular assays. Given their significantly higher acceptability ratings, self-collected ON swabs should be considered as a potential less-invasive diagnostic option for children. Disclosures All Authors: No reported disclosures
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".