Rapid flu test curbs diagnostic testing in the ER

A point-of-care rapid influenza test used during the flu season in the pediatric emergency department of a children’s hospital was sensitive and specific for influenza infection, and led to less diagnostic testing, a Tennessee-based team of doctors found.

“Influenza is one of the common causes of illness during the winter,” lead researcher Dr. Katherine A. Poehling pointed out in remarks to Reuters Health. “We found that rapid influenza tests were associated with fewer tests being ordered in the emergency department.”

To investigate the impact of such testing, Poehling and colleagues at Vanderbilt University Medical Center, Nashville, conducted a study during the influenza seasons between 2002 and 2004. Surveillance days were randomly allocated to use or non-use of the test. Rapid results were compared with results of standard culture or another method of detecting viruses called PCR.

In total, 306 children with fever or acute respiratory symptoms attending the emergency department and 162 attending the hospital acute care clinic were enrolled. All were younger than 5 years of age.

Overall, 88 children (19 percent) had influenza. In the rapid testing group, 51 (25 percent) had influenza. The test had a sensitivity of detecting influenza of 82 percent and a specificity for influenza of 99 percent.

The rapid test led to fewer emergency department children having diagnostic tests (39 percent versus 51 percent). However there was no difference in those attending the acute care clinic. There was no difference in antibiotic prescribing in either setting.

In a report in the Archives of Pediatrics and Adolescent Medicine, the researchers call for further studies, but note the value of a reduction in unnecessary diagnostic testing during the influenza seasons when such facilities are often overcrowded.

However, added Poehling, “because prevention is better than being diagnosed with influenza, parents—particularly those with children 6 months up to 5 years of age and those with medical conditions such as asthma—should talk to their doctors about the influenza vaccine.”

SOURCE: Archives of Pediatrics and Adolescent Medicine, July 2006.

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