Rapid responses are electronic comments to the editor. They enable our users to debate issues raised in articles published on bmj.com. A rapid response is first posted online. If you need the URL (web address) of an individual response, simply click on the response headline and copy the URL from the browser window. A proportion of responses will, after editing, be published online and in the print journal as letters, which are indexed in PubMed. Rapid responses are not indexed in PubMed and they are not journal articles. The BMJ reserves the right to remove responses which are being wilfully misrepresented as published articles.
Criticism of the Liverpool lateral flow testing pilot has focused on “false negatives”, but “false positives” are also a problem. From the available data, one in two of the positive results by LFT in Liverpool will be “false positives”. People with a positive test result are instructed to self-isolate and to get a confirmatory PCR, but the latter is omitted from the text message they receive from NHS Test & Trace.  Neither the proportion who then get a PCR test, nor the proportion confirmed by PCR, are publicly available.
The scale of the “false positive” problem is apparent from the Government data on sensitivity (58%) and specificity (99.68%), together with the number of Liverpool residents tested by LFT (119,456 as of 2 Dec) and the number with positive result (798). From these figures, the prevalence in the relevant population – those Liverpool residents who choose to take an LFT test – is 0.6% and the positive predictive value, in this population, is 52%.
Neither the Liverpool City Council FAQs  nor the Government’s Annex B  acknowledge the scale of the problem. The FAQs simply state “there is a possibility that some people who test positive with LFT are 'false positive' and the gold standard PCR test will identify these.” Annex B says “The virus prevalence is around 1% in the country, so we expect around 7 true positives and 4 false positives for every 1000 people tested.”
The national value, including both symptomatic and asymptomatic cases, is not the relevant prevalence, but it suggests that the Government may also envisage using LFT on symptomatic cases, a possibility which is not excluded in the FAQs.