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. 2024 Jul 30;4(7):e0003547.
doi: 10.1371/journal.pgph.0003547. eCollection 2024.

Diagnostic testing preferences can help inform future public health response efforts: Global insights from an international survey

Leah Salzano  1 , Nithya Narayanan  1 , Emily R Tobik  1 , Sumaira Akbarzada  1 , Yanjun Wu  1 , Sarah Megiel  2 , Brittany Choate  1   3 , Anne L Wyllie  1
Affiliations

Diagnostic testing preferences can help inform future public health response efforts: Global insights from an international survey

Leah Salzano et al. PLOS Glob Public Health. .

Abstract

Public perception regarding diagnostic sample types as well as personal experiences can influence willingness to test. As such, public preferences for specific sample type(s) should be used to inform diagnostic and surveillance testing programs to improve public health response efforts. To understand where preferences lie, we conducted an international survey regarding the sample types used for SARS-CoV-2 tests. A Qualtrics survey regarding SARS-CoV-2 testing preferences was distributed via social media and email. The survey collected preferences regarding sample methods and key demographic data. Python was used to analyze survey responses. From March 30th to June 15th, 2022, 2,094 responses were collected from 125 countries. Participants were 55% female and predominantly aged 25-34 years (27%). Education and employment were skewed: 51% had graduate degrees, 26% had bachelor's degrees, 27% were scientists/researchers, and 29% were healthcare workers. By rank sum analysis, the most preferred sample type globally was the oral swab, followed by saliva, with parents/guardians preferring saliva-based testing for children. Respondents indicated a higher degree of trust in PCR testing (84%) vs. rapid antigen testing (36%). Preferences for self- or healthcare worker-collected sampling varied across regions. This international survey identified a preference for oral swabs and saliva when testing for SARS-CoV-2. Notably, respondents indicated that if they could be assured that all sample types performed equally, then saliva was preferred. Overall, survey responses reflected the region-specific testing experiences during the COVID-19. Public preferences should be considered when designing future response efforts to increase utilization, with oral sample types (either swabs or saliva) providing a practical option for large-scale, accessible diagnostic testing.

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Conflict of interest statement

I have read the journal’s policy and the authors of this manuscript have the following competing interests: ALW has received consulting and/or advisory board fees from Pfizer, Merck, Diasorin, PPS Health, Co-Diagnostics, and Global Diagnostic Systems for work unrelated to this project, and is Principal Investigator on research grants from Pfizer, Merck, NIH RADx UP and SalivaDirect, Inc. to Yale University and from NIH RADx, Balvi.io and Shield T3 to SalivaDirect, Inc. All other co-authors declare no potential conflict of interest.

Figures

Fig 1
Fig 1. Preference for diagnostic sample types by region, when study participants were asked to assume equal accuracy in testing performance.
See this image and copyright information in PMC

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Grants and funding

The study was supported by SalivaDirect, Inc (ALW). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The study protocol was designed by the Yale researchers. The decision to publish was made by the Yale researchers; all authors agree with the decision to publish and with the results of the study.

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