National swine flu adult assessment guidelines: retrospective validation of objective criteria in three proxy datasets.
OBJECTIVE
To validate the objective criteria in the Department of Health Adult Swine Flu Assessment Tool against proxy datasets for pandemic influenza.


METHODS
Comparative validation study with 3 datasets.


METHODS
Urban Emergency Department (group 1) and prehospital care (groups 2 and 3).


METHODS
Adults with community-acquired pneumonia (group 1, n=281), shortness of breath (group 2, n=211) or any respiratory diagnosis (group 3, n=300).


METHODS
Hospital admission (group 1), hospital admission or intravenous therapy (group 2) and transfer to emergency department (group 3).


RESULTS
Sensitivity and specificity of the tool were 0.73 (95% CI 0.67 to 0.8) and 0.83 (0.72 to 0.9) in group 1, 0.64 (0.55 to 0.71) and 0.63 (0.52 to 0.73) in group 2 and 0.84 (0.75 to 0.9) and 0.55 (0.48 to 0.62) in group 3. Analysis of individual components of the tool and a summative score is presented.


CONCLUSIONS
The objective criteria of the proposed DH assessment tool do not perform particularly well in predicting relevant clinical outcomes in feasible proxy conditions for pandemic influenza.
Challen
K
K
Emergency Medicine, Central Manchester Foundation Trust, Oxford Road, Manchester M13 9WL, UK. kirstychallen@hotmail.com
Bentley
A
A
Bright
J
J
Gray
J
J
Walter
D
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D017714:Community-Acquired Infections / Q000175:diagnosis*; D015897:Comorbidity; D003657:Decision Making; D004636:Emergency Service, Hospital; D004739:England / Q000453:epidemiology; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000175:diagnosis* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D058873:Pandemics; D017410:Practice Guidelines as Topic; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity