New Clinical Decision Guideline for Influenza Testing in High-Risk Adults

A four-item tool based on signs and symptoms could reduce testing by roughly one third.

The Centers for Disease Control and Prevention recommends antiviral treatment in high-risk adults testing positive for influenza (https://www.cdc.gov/flu/professionals/antivirals/summary-clinicians.htm#table2). Unfortunately, no highly sensitive decision rules exist to identify which emergency department (ED) patients should undergo testing.

To address this gap, researchers prospectively enrolled 1941 adults who presented to four U.S. EDs during the 2013–2014 flu season with fever or respiratory symptoms and qualified for antiviral treatment per 2013 CDC guidelines. Overall, 9% of patients had confirmed influenza. A clinical decision tool was derived from 43 demographic, symptom, medical history, and physical exam variables.

The final tool in…

Reviewing Author

Jason T. McMullan, MD, MS, FAEMS

Disclosures

Consultant/Advisory BoardEMCREG International

Grant/Research SupportNIH; Department of Defense

Editorial BoardsJournal of Emergency Medical Services

Leadership Positions in Professional SocietiesNational Association of EMS Physicians (Chair, Research Committee)