Listen to the JALMTalk Podcast
Gregory J. Berry, et al. Comparison of the Alere i and BD Veritor Assays for the Rapid Detection of Influenza A
and B Viruses. J Appl Lab Med 2017;1:735-39.
Dr. Gregory Berry is assistant professor of Pathology and Laboratory
Medicine at Hofstra Northwell School of Medicine in New York and assistant
director of Infectious Disease Diagnostics at Northwell Health Laboratories.
Hello, and welcome to this edition of “JALM Talk” from The
Journal of Applied Laboratory Medicine, a publication of the
American Association for Clinical Chemistry. I’m your host,
The use of point of care testing in outpatient clinics and
doctors’ offices for patient management decisions is
becoming more common. Although these tests are
generally faster and more user-friendly than central
laboratory equipment, they are still expected to have
acceptable performance including accuracy, precision,
sensitivity, and specificity for the analyte that they’re
An article called “Comparison of the Alere i and BD Veritor
Assays for the Rapid Detection of Influenza A and B
Viruses,” published in the May 2017 issue of JALM,
compared the ability of two point of care devices to detect
influenza A and B separately and quantitatively. These
assays use different analytical techniques, where one is a
rapid isothermal nucleic acid amplification assay, and the
other is a chromatographic immunoassay. Samples with
discordant results were subsequently analyzed using real
The first author of this article is Dr. Gregory Berry, assistant
professor of Pathology and Laboratory Medicine at Hofstra
Northwell School of Medicine in New York and assistant
director of Infectious Disease Diagnostics at Northwell
Health Laboratories, and he’s our guest for today’s podcast.
Welcome, Dr. Berry.
To begin, why you don’t just tell us a bit about your study?
So as you stated in your introduction, point of care testing is
becoming increasingly more common, and these results
have a direct impact on patient care decisions. Since the
results of these tests are used to direct patient care, it is
imperative that the results are accurate and reliable, and that the studies are done to look at the performance of
these assays. Our special interest was influenza point of
care testing. We looked at two point of care tests on the
market to detect influenza A and B viruses. These tests
were the BD Veritor, which is a point of care test and is a
more established chromatographic immunoassay in the
realm of point of care testing, while the other, the Alere i, is
a newer technology that uses nucleic acid amplification for
pathogen detection. So our goal is to evaluate these assays
and look at how the new molecular based Alere i assay
performs in comparison to the BD Veritor immunoassay.
Okay. So now what new information do you think that the
study is going to bring to the table for the clinics and the
health systems trying to make a choice between these new
molecular technologies and the rapid antigen test with which
they’re already familiar?
I think our study highlights a typical choice that’s faced by
clinics and health systems every day. And that choice is
looking at two tests that seemingly do the same thing and
then trying to make a decision to which one they’re going to
pick based on the various different factors that come into
play, such analytical performance, ease of use, cost, and
many other considerations.
In this case, our study compared the performance of these
two tests over two consecutive influenza seasons, and found
that the Alere i performed better in the detection of
influenza A than the BD Veritor. The ability to detect the
pathogen for which you’re testing is of course of one of the
critical components to be considered when picking a new
test. So that being said, we hope that the conclusions of
our study can be used as part of an assay platform decision
that a health system or a clinic would need to make.
Okay, make sense. I’d like to know though, you ran this
test yourself, I understand? And two questions, do you find
it easy to use? And also based on your experience and your
observation, do you think it would fit well as a point of care
test in the clinic?
Yeah. Actually, both assays were easy to use, but since the
Alere i is the newer platform and it outperformed the Veritor
in our study, I’ll talk about the Alere specifically. Yeah, I did
run the Alere i myself and I did find it easy to use. The
design of the assay wasn’t overly complicated and it’s a
quick set-up and a less than 15-minute results from the
time of set-up to the time of result. So I think it would fit
quite well in the clinic setting. One of the things that I
found is the display screen on the instrument prompts the
user to perform each necessary step, which I thought was a real added plus and should really help clinic staff in running
Okay, so molecular testing sounds like it has an advantage,
especially in increased sensitivity over rapid antigen testing.
But are there any drawbacks?
One big drawback is that molecular testing has a higher
price in general and is typically higher than the test that it’s
looking to replace. So the cost is higher, but that being
said, I know that the reimbursement rates have been
adjusted to reflect this cost increase.
Also another point to consider is that more accurate test
result should lead to better patient care. That’s always the
goal in this type of testing. So if we’re using a better test
that the cost factor is not as — is maybe not as great.
Okay, that makes sense actually, but bearing all this in
mind, what direction do you see point of care testing for
infectious diseases going, over say the next five years?
So I’d say over the next five years, we’re going to see a
great deal more infectious disease testing. It’s going to
enter the point of care arena. I think that the convenience
of the test results right at the patient’s bedside or in the
clinic during a sick visit really can’t be denied. Those are
huge perks to have the test result. Now that being said,
test results obtained from point of care testing need to
reach the same level of sensitivity and specificity as our
current laboratory performed diagnostic test if they're ever
to become the primary tool used in the diagnosis of any
infection. Comprehensive evaluations of these types of
point of care tests will really be key as we move forward.
Very interesting. Thank you so much for joining us today
It’s my pleasure.
That was Dr. Gregory Berry from Northwell Health
Laboratories talking about the JALM article, “Comparison of
the Alere i and BD Veritor Assays for the Rapid Detection of
Influenza A and B Viruses” for this podcast. Thank for
tuning in for “JALM Talk.” See you next time and don’t
forget to submit something for us to talk about!