Accuracy and Impact of a Point-of-Care Rapid Influenza Test in Young Children With Respiratory Illnesses
Open Access
- 1 July 2006
- journal article
- research article
- Published by American Medical Association (AMA) in Archives of Pediatrics & Adolescent Medicine
- Vol. 160 (7), 713-718
- https://doi.org/10.1001/archpedi.160.7.713
Abstract
Objective To determine whether a point-of-care rapid influenza test impacts the diagnostic evaluation and treatment of children with acute respiratory illnesses. Design Randomized controlled trial. Setting Pediatric emergency department and acute care clinic of a children's hospital. Participants Children aged younger than 5 years with fever or acute respiratory symptoms during 2 influenza seasons (2002 through 2004). Interventions Surveillance days were randomized to performance or no performance of a point-of-care rapid influenza test. All children had a nasal and throat swab obtained for laboratory tests. The rapid test group had another nasal swab obtained for the QuickVue Influenza Test (Quidel Corp, San Diego, Calif), which was performed by nurses; results were shared immediately with treating physicians. Main Outcome Measures Rapid test results were compared with results of the viral culture or 2 polymerase chain reaction assays for influenza. Diagnostic test ordering and antibiotic prescribing were compared for the groups. Results Of 468 enrolled children, 306 were from the emergency department and 162 from the clinic. Overall, 88 children (19%) had influenza infection. Of 205 children in the rapid test group, 51 (25%) had influenza infection. The rapid influenza test was 82% sensitive and 99% specific. In the emergency department, fewer children in the rapid test group had diagnostic tests ordered than in the no rapid test group (39% vs 51%, P = .03). There was no difference in test ordering in the clinic or in antibiotic prescribing in either setting. The use of antivirals was low. Conclusions Point-of-care rapid influenza tests were sensitive and specific and were associated with less diagnostic testing in the emergency department.Keywords
This publication has 14 references indexed in Scilit:
- QIAamp MinElute Virus kit effectively extracts viral nucleic acids from cerebrospinal fluids and nasopharyngeal swabsJournal of Clinical Virology, 2006
- Influenza virological surveillance in children: The use of the Quickvue rapid diagnostic testJournal of Medical Virology, 2004
- Superiority of Reverse‐Transcription Polymerase Chain Reaction to Conventional Viral Culture in the Diagnosis of Acute Respiratory Tract Infections in ChildrenThe Journal of Infectious Diseases, 2004
- Comparison of Lateral-Flow Immunoassay and Enzyme Immunoassay with Viral Culture for Rapid Detection of Influenza Virus in Nasal Wash Specimens from ChildrenJournal of Clinical Microbiology, 2003
- Evaluation of a rapid test (QuickVue) compared with the shell vial assay for detection of influenza virus clearance after antiviral treatmentJournal of Virological Methods, 2003
- Bedside Diagnosis of Influenzavirus Infections in Hospitalized ChildrenPublished by American Academy of Pediatrics (AAP) ,2002
- QuickVue Influenza Test for Rapid Detection of Influenza A and B Viruses in a Pediatric PopulationClinical and Vaccine Immunology, 2002
- Evaluation of diagnostic tests for influenza in a pediatric practiceThe Pediatric Infectious Disease Journal, 2002
- Influenza and the Rates of Hospitalization for Respiratory Disease among Infants and Young ChildrenNew England Journal of Medicine, 2000
- The Effect of Influenza on Hospitalizations, Outpatient Visits, and Courses of Antibiotics in ChildrenNew England Journal of Medicine, 2000