Emergency Department Clinicians Struggle to Diagnose Influenza on Clinical Grounds Alone

The CDC recommends antiviral treatment for patients with influenza who have a severe or complicated course of illness, are at high risk for complications, or require hospitalization. In a prospective observational cohort study conducted at a single U.S. emergency department (ED), investigators assessed clinicians' ability to diagnose influenza based on history and physical exam alone, with blinded polymerase chain reaction (PCR) results as the gold standard. All participants met CDC criteria for antiviral treatment, if diagnosed with influenza.

Of the 270 patients, 16% had influenza by PCR. Clinical diagnosis of influenza had a sensitivity of 36% and a specificity of 78%. Only 36% of the patients with PCR-confirmed influenza received antivir…