title: Variability in the diagnostic performance of a bedside rapid diagnostic influenza test over four epidemic seasons in a pediatric emergency department.
abstract: We wanted to determine the diagnostic performance of a rapid influenza diagnostic test (RIDT) used bedside in a pediatric emergency department (PED). This was a prospective study over four consecutive winters (2009-2013), comparing the results of a RIDT (QuickVue®) with RT-PCR in children admitted to a PED. Among the 764 children included, we did not observe any significant differences in the diagnostic performance of RIDT except during the H1N1 pandemic. The overall sensitivity of the test was 0.82; the specificity 0.98; the positive and negative likelihood ratios 37.8 and 0.19. The positive and negative post-test probabilities of infection were 98% and 17%. The diagnostic performance was increased for influenza B cases (P = 0.03). RIDTs are suitable for use every winter with few differences in its diagnostic value, except during specific pandemic periods. This test could limit unnecessary complementary exams and guide the prescription of antivirals during influenza epidemic periods in PEDs.
authors.affiliation: Pediatrics emergency department, University Hospital, Nantes, France.
authors.forename: E
authors.initials: E
authors.lastname: Avril
authors.affiliation: Pediatrics emergency department, University Hospital, Nantes, France.
authors.forename: S
authors.initials: S
authors.lastname: Lacroix
authors.affiliation: Pediatrics emergency department, University Hospital, Nantes, France.
authors.forename: B
authors.initials: B
authors.lastname: Vrignaud
authors.affiliation: Laboratory of Virology, University Hospital, Nantes, France.
authors.forename: A
authors.initials: A
authors.lastname: Moreau-Klein
authors.affiliation: Laboratory of Virology, University Hospital, Nantes, France.
authors.forename: M
authors.initials: M
authors.lastname: Coste-Burel
authors.affiliation: Pediatrics emergency department, University Hospital, Nantes, France; Department of Pediatrics, University Hospital, Nantes, France.
authors.forename: E
authors.initials: E
authors.lastname: Launay
authors.affiliation: Pediatrics emergency department, University Hospital, Nantes, France; Department of Pediatrics, University Hospital, Nantes, France; Center of Clinical Investigation for Woman, Child and Adolescent, University Hospital, Nantes, France. Electronic address: christele.grasleguen@chu-nantes.fr.
authors.forename: C
authors.initials: C
authors.lastname: Gras-Le Guen
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003955:Diagnostic Tests, Routine / Q000379:methods*; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007251:Influenza, Human / Q000175:diagnosis*; D008297:Male; D019095:Point-of-Care Systems; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity
keywords: Diagnostic performance; Epidemic seasons; RIDT; Sensibility