The tests are realistically about 99% accurate if used properly and not faulty.
What you have to remember is that they can only pick up hormone levels once they reach a certain level within the urine - and it is different for the various brands of tests. And then they rely on averages for hcg levels (the hormone that they pick up) when they talk about which days after your period is due that they will pick up a pregnancy.
There will always be people that for whatever reason they don't work for - most likely because there is something else in the urine that is interfering with the test - that is why they aren't ever given 100% accuracy.
So, in answer to your question - the tests are actually really good and have all passed really strict tests for accuracy before they are approved for sale in Australia (yep - there is a govt department that employs people to make sure that pregnancy tests are accurate!) - no guarantees if you buy imported ones off ebay or the like.
Most false negatives are because the person is not using them properly or it is just too early to pick up the pregnancy (which is why the suggest on the packaging that if you get a negative but suspect that you are preg you should retest several days later).
False positives (that are actual false positives rather than very early miscarriages and chemical pregnancies) are extremely rare and are caused by a faulty test (which isn't unheard of) or if the woman is excreting something in her urine that replicates the hcg - some powerful prescription medications (can't remember which ones this minute) are known to have this effect.
Hope that this helps.




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