False positives do not always indicate a miscarriage. False positives happen, rarely, but they happen. Just like false negatives. (which are more common than false positives.)
False positives imply a miscarriage but false negatives are fairly common. Especially if you don't know precisely when you ovulated, you could be testing to early for there to be enough of the correct hormones. I had a friend who was pregnant, confirmed by a blood test, and at 5 months she finally tested positive. Basically if you're that unsure and it's possible that you could be, then see your Dr.
Should be accurate. But IF you're uncertain, get a blood test done