Annals of Internal Medicine: Accuracy of Rapid Influenza Diagnostic Tests: A Meta-analysis

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Accuracy of Rapid Influenza Diagnostic Tests: A Meta-analysis

1. Caroline Chartrand, MD, MSc;
2. Mariska M.G. Leeflang, DVM, PhD;
3. Jessica Minion, MD, MSc;
4. Timothy Brewer, MD, MPH; and
5. Madhukar Pai, MD, PhD

Abstract

Background: Timely diagnosis of influenza can help clinical management.

Purpose: To examine the accuracy of rapid influenza diagnostic tests (RIDTs) in adults and children with influenza-like illness and evaluate factors associated with higher accuracy.

Data Sources: PubMed and EMBASE through December 2011; BIOSIS and Web of Science through March 2010; and citations of articles, guidelines, reviews, and manufacturers.

Study Selection: Studies that compared RIDTs with a reference standard of either reverse transcriptase-polymerase chain reaction (first choice) or viral culture.

Data Extraction: Reviewers abstracted study data by using a standardized form and assessed quality by using Quality Assessment of Diagnostic Accuracy Studies criteria.

Data Synthesis: There were 159 studies that evaluated 26 RIDTs, and 35% were conducted during the H1N1 pandemic. Failure to report whether results were assessed in a blinded manner and the basis for patient recruitment were important quality concerns. The pooled sensitivity and specificity were 62.3% (95% CI, 57.9% to 66.6%) and 98.2% (CI, 97.5% to 98.7%), respectively. The positive and negative likelihood ratios were 34.5 (CI, 23.8 to 45.2) and 0.38 (CI, 0.34 to 0.43), respectively. Sensitivity estimates were highly heterogeneous, which was partially explained by lower sensitivity in adults (53.9% [CI, 47.9% to 59.8%]) than in children (66.6% [CI, 61.6% to 71.7%]) and a higher sensitivity for influenza A (64.6% [CI, 59.0% to 70.1%) than for influenza B (52.2% [CI, 45.0% to 59.3%).

Limitation: Incomplete reporting limited the ability to assess the effect of important factors, such as specimen type and duration of influenza symptoms, on diagnostic accuracy.

Conclusion: Influenza can be ruled in but not ruled out through the use of RIDTs. Sensitivity varies across populations, but it is higher in children than in adults and for influenza A than for influenza B.

Primary Funding Source: Canadian Institutes of Health Research.

http://www.annals.org/content/early/2012/02/27/0003-4819-156-7-201204030-00403.abstract

Full text at: http://www.annals.org/content/early/2012/02/27/0003-4819-156-7-201204030-00403.full

 

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Re: Annals of Internal Medicine: Accuracy of Rapid Influenza Diagnostic Tests: A Meta-analysis

How accurate are rapid flu tests? New research could lead to more timely diagnosis


stitute of the McGill University Health Centre (RI MUHC), and Sainte-Justine University Hospital Research Centre, Montreal, has put the accuracy of rapid influenza diagnostic tests (RIDTs) under the microscope. The meta-analysis of 159 studies showed three key findings: that RIDTs can be used to confirm the flu, but not to rule it out; that test accuracy is higher in children than it is in adults; and that RIDTs are better at detecting the more common influenza A virus than they are at detecting influenza B.

The research, led by by Dr. Caroline Chartrand, Sainte-Justine Hospital staff pediatrician and researcher, was published this week in the Annals of Internal Medicine.

Early flu diagnosis is key for both optimal patient care and infection control. While viral culture and reverse transcriptase polymerase chain reaction (RT-PCR) tests have been the gold-standards for detecting influenza, they can be expensive and the turn-around time for results range from one to 10 days. RIDTs attempt to overcome some of these problems. They are simple to use, give results in 15 to 30 minutes without having to be sent to a lab and in most cases, can be administered in routine clinical settings, like a doctor's office or emergency departments.

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http://medicalxpress.com/news/2012-02-accurate-rapid-flu-diagnosis.html

 

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Re: Annals of Internal Medicine: Accuracy of Rapid Influenza Diagnostic Tests: A Meta-analysis

Source: http://www.news-medical.net/news/20...ghly-accurate-in-children-than-in-adults.aspx

Rapid influenza diagnostic tests highly accurate in children than in adults
Published on February 28, 2012 at 3:31 AM ?

New research could lead to more timely diagnosis and aid clinical management during flu season

A new study conducted by researchers from McGill University, the Research Institute of the McGill University Health Centre (RI MUHC), and Sainte-Justine University Hospital Research Centre, Montreal, has put the accuracy of rapid influenza diagnostic tests (RIDTs) under the microscope. The meta-analysis of 159 studies showed three key findings: that RIDTs can be used to confirm the flu, but not to rule it out; that test accuracy is higher in children than it is in adults; and that RIDTs are better at detecting the more common influenza A virus than they are at detecting influenza B...