Influenza point-of-care test in the GP practice and Emergency Department; analytical accuracy and added value

• Published in: Nederlands tijdschrift voor geneeskunde Vol. 163
• Main Authors: Verhees, Ruud A F, Lutgens, Suzanne P M, Kusters, Ron, Dinant, Geert-Jan, Cals, Jochen W L
• Format: Journal Article
• Language: Dutch
• Published: Netherlands 29-08-2019
• Subjects: Anti-Bacterial Agents - therapeutic use; Emergency Service, Hospital; General Practice; Humans; Influenza A virus - genetics; Influenza, Human - diagnosis; Influenza, Human - virology; Length of Stay; Mass Screening - methods; Outcome Assessment, Health Care; Point-of-Care Systems; Point-of-Care Testing; Polymerase Chain Reaction; Reproducibility of Results; Sensitivity and Specificity
• EISSN: 1876-8784
• ISSN: 0028-2162

An influenza epidemic can greatly increase the workload in primary care and the emergency department (ED) and can even disrupt the healthcare system. It is difficult to diagnose influenza by history taking and physical examination. A fast diagnosis usinginfluenza point-of-care tests (POCTs) could reduce unnecessary antibiotic prescriptions, diagnostic tests, consultations and hospital admissions. Moreover, length of stay on EDs and length of admission could be shortened. The analytical accuracy of antigen detection tests for influenza is relatively low compared to the well performing RT-PCR assays (sensitivity and specificity approximately 95%). Only 1 randomized controlled trial has shown the effect of a (combined) RT-PCR assay for influenza detection on clinically relevant outcome measures. Observational research suggests that introduction of RT-PCR assays for influenza detection reduces length of stay on the ED and decreased time from sample reception to result. For practical reasons, we should embrace the introduction of RT-PCR assays for influenza detection on EDs. Before POCTs can be implemented in primary care (family medicine) the analytical accuracy and time to receive results should be improved and effects of its clinical impact should be proven.