Print E-mail
Volume 45, Number 4, August 2012

 A scoring system for predicting results of influenza rapid test in children: A possible model facing overwhelming pandemic infection


Chien-Yu Lin, Hsin Chi, Hsiang-Yu Lin, Lung Chang, Jen-Yin Hou, Ching-Ting Huang, Hung-Chang Lee, Ming-Ren Chen, Chun-Chih Peng, Daniel Tsung-Ning Huang, Nan-Chang Chiu


Received: March 7, 2011    Revised: July 12, 2011    Accepted: August 15, 2011   

 

Corresponding author:

Nan-Chang Chiu, Corresponding author. Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan. E-mail address: ncc88@ms2.mmh.org.tw (N.-C. Chiu).



 

Background and purpose: 

 The pandemic novel influenza H1N1 (swine) influenza A virus (H1N1v) infection has caused large-scale community infection in Taiwan. Anxiety developed in the general public and physicians faced a huge challenge in many aspects. We conducted this prospective study to develop a scoring system based on the clinical manifestations for predicting the results of influenza rapid testing, as a surrogate of influenza rapid testing, to lower the anxiety and decrease the burden for the test.



 

Methods:

 From September 1, 2009 to October 5, 2009, pediatric patients who received influenza rapid tests were enrolled, and questionnaires were recorded and analyzed in the first 2 weeks. A further scoring system was conducted to predict the results of influenza rapid tests and validated in the next 3 weeks.



 

Results:

 Eight hundred and forty-five children were enrolled in our study. In the first phase, data from 506 patients showed that those with age  5 years, fever  38C, contact history of influenza A infection, myalgia, lethargy, sore throat, cough, and headache had a higher risk of positive results (odds ratio: 1.1e2.53). A scoring system was designed, with 5 points indicating acceptable sensitivity (69.5%) and specificity (63.6%). Three hundred and thirty-nine patients in the second phase were enrolled to validate the scoring system and the positive and negative predictive values were 52.0% and 73.8%.



 

Conclusion:

 The emergence of H1N1v infection is not only an important medical issue, but also a socioeconomic problem. Based on easily available clinical information, we develop a scoring system as a preliminary screening tool for the general public and first-line health care providers to evaluate the possibility of influenza virus infection. Although this study was limited by the sensitivity of rapid tests, this type of model may be a surrogate weapon when faced with overwhelming pandemic infection in the future, especially in areas with scarce medical resources.



 

Key words:

 Children; H1N1 influenza virus; Influenza; Public anxiety; Scoring system