Dugas et al reported a simple clinical decision guideline for ordering influenza testing in the Emergency Department. The authors are from the Johns Hopkins University, University of Arizona, University of California in Los Angeles and University of Missouri Kansas City.
Patient selection: adult with fever or respiratory symptoms from November to April
Testing: influenza by PCR
Parameters:
(1) new or increased cough
(2) headache
(3) subjective fever
(4) triage temperature in °C
Parameter
Finding
Points
new or increased cough
no
0
yes
2
headache
no
0
yes
1
subjective fever
no
0
yes
1
triage temperature
<= 100.4°C
0
> 100.4°C
1
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 5
• A score >= 3 identifies a person who should be tested.
Performance:
• The sensitivity was 92-94% and specificity 35-37%.
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