Clinical and Economic Evaluation of Rapid Influenza A Virus Testing in Nursing Homes in Calgary, Canada

Abstract

The incremental benefits and costs of a rapid influenza A virus infection diagnostic service were studied in nursing homes in Calgary, Canada, during a single influenza season. The service was used to test 159 patients with suspected infection in a group of "experimental" nursing homes and results were compared with those for a group of "control" homes. An equal number of cases of influenza were identified in each group. Twenty-eight patients (17.6%) had confirmed cases, and 63 patients (39.6%) had probable cases. A rapid viral test result was provided much faster for patients in the experimental homes (P=.005). Both groups had the same median attack rate for influenza A virus. In experimental homes, the duration of the outbreak was shorter (P=.03), and the cost of laboratory testing and the total cost (less the hospital cost) tended to be lower (P<.2). The rapid testing service also tended to lower the overall use of resources.

Evaluation of a Multiplexed PCR Assay for Detection of Respiratory Viral Pathogens in a Public Health Laboratory Setting

“…Laboratory-based surveillance programs for influenza-like illnesses are critical to providing information concerning the presence of the virus. Surveillance and early diagnosis have been shown to result in timely administration of antiviral drugs to decrease the duration of outbreaks and lower total costs due to illness (7). They also prevent the inappropriate use of antibiotics (3).…”

Evaluation of Three Immunoassay Kits for Rapid Detection of Influenza Virus A and B

“…In addition, early therapeutic interventions are recommended for high-risk patients in order to decrease the morbidity and mortality caused by influenza (5,9). The effectiveness of these strategies, however, is predicated on rapid, sensitive, and specific diagnosis of the infection (4).…”

Comparison of the Directigen Flu A+B Test, the QuickVue Influenza Test, and Clinical Case Definition to Viral Culture and Reverse Transcription-PCR for Rapid Diagnosis of Influenza Virus Infection

“…Rapid diagnosis of influenza permits the institution of antiviral treatment, helps to control nosocomial transmission of the infection, and contributes to reductions in the cost and the length of the hospital stay. Rapid diagnosis has previously been shown to be cost-effective in a pediatric hospital (29,43) and useful for controlling influenza epidemics in geriatric institutions (8,24).…”

“…), QuickVue influenza test (referred to herein as QuickVue; Quidel, San Diego, Calif.), Flu OIA (Bio Star, Inc., Boulder, Colo.,) and Zstat (ZymeTx, Inc., Oklahoma City, Okla.). Most of them have been compared with culture (8,12,20,23,24,29,33,34,36,39,44,45) or culture and reverse transcription (RT)-PCR (2,18,21,22,25), but in some studies RT-PCR has occasionally been used to clarify the results for samples with discrepant results (6,11,28). This study aimed to evaluate the accuracy of the clinical case definition of influenza for prediction of influenza virus infections during epidemics and to compare the diagnostic performances of two new enzyme-linked immunosorbent assays, Directigen and QuickVue, to those of viral culture and an in-house RT-PCR.…”