Accuracy of Rapid Influenza Diagnostic Tests: A Meta-analysisFREE
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Abstract
Background:
Purpose:
Data Sources:
Study Selection:
Data Extraction:
Data Synthesis:
Limitation:
Conclusion:
Primary Funding Source:
Methods
Data Sources and Searches
Study Selection
Data Extraction and Quality Assessment
Data Synthesis and Analysis
Role of the Funding Source
Results
Study Selection
Characteristics of Included Studies
Quality of Included Studies
Overall Accuracy of RIDTs
Investigation of Heterogeneity
Discussion
References
Information & Authors
Information
Published In
History
Keywords
- Age groups
- Allergy and immunology
- Antigens
- Children
- Diagnostic medicine
- Diagnostic techniques
- Epidemiology
- Immune physiology
- Immunoassays
- Molecular biology
- Polymerase chain reaction
- Population statistics
- Prevention, policy, and public health
- Research and reporting methods
- Research assessment
- Research facilities
- Statistical methods
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Accuracy of Rapid Influenza Diagnostic Tests: A Meta-analysis. Ann Intern Med.2012;156:500-511. [Epub 3 April 2012]. doi:10.7326/0003-4819-156-7-201204030-00403
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RIDT Performance: Health-Economic Implications
The study done by Chartrand et. at. (Ann Intern Med. 2012;156:500- 511) is a well-done and comprehensive metaanalysis of 26 rapid influenza diagnostic tests' (RIDT) performance in adults and children with influenza -like illness (ILI). Fundamentally, the pooled RIDT performance reported by this study (sensitivity 62.3%, 95% CI 57.9% to 66.6%; specificity 98.2%, CI 97.5% to 98.7%) is the same as that previously reported (sensitivity 72%, CI 62-81; specificity 96%, CI 93-97%) for one widely- used commercial RIDT prior to the H1N1 pandemic (1).
It is important to consider these findings in the context of the commonly used alternative of unaided clinical diagnosis for ILI, where the pooled sensitivity is essentially the same as that of the RIDT (65%, CI 55 -74%), but specificity is about 30% lower (67%, CI 57-76%). This consideration has important health-economic implications. For example, the 8-fold higher false positive rate with unaided clinical ILI diagnosis will predictably lead to more non-indicated antiviral therapy (and associated complications and costs), possible promotion of antiviral drug resistance, complications of undiagnosed or untreated bacterial illness, or undetected illnesses other than influenza. In addition to these clinical implications, the estimated average cost to prevent one false positive result by using RIDTs in place of unaided ILI diagnosis would be -$30.02 to -$11.02 (i.e., $11.02 to $30.02 savings), $8.29 to $41.54, and $123.22 to $199.22, respectively during the peri-influenza, influenza, and epidemic influenza seasons (1).
References
1. Petrozzino JJ, Smith C, Atkinson MJ. Rapid diagnostic testing for seasonal influenza: an evidence-based review and comparison with unaided clinical diagnosis. J Emerg Med. 2010;39:476-490.e1. [PMID: 20227846]
Conflict of Interest:Jeffrey Petrozzino and Mark J. Atkinson were employees or consultants of The Aequitas Group, Inc. between September 2007 and September 2008.