Every year, influenza season travels the globe, led by the four horsemen of the apocalypse, bringing toys and good cheer to obedient little girls and boys. Unfortunately, this very same influenza contributes to hundreds of thousands of hospitalizations and tens of thousands of deaths in the U.S. alone. And, despite such ubiquity, clinicians are utterly inept at rapid, accurate diagnosis.
This small study reviews the diagnostic performance of clinicians at a single hospital during the influenza season of 2012-13. A convenience sample of 270 patients presenting with any history of respiratory or febrile illness were screened and swabbed for influenza, and the results of eventual PCR testing were compared with the sensitivity of the CDC definition of “influenza-like illness” and accuracy of subsequent clinical diagnosis.
The highlights:
- 42 of 228 patients were positive for influenza.
- Only 40 out of the entire cohort of 270 met the CDC definition of ILI, a cough or sore throat coupled with fever.
- 15 of influenza positive patients were thought to have influenza by the treating clinician, as well as 50 of the influenza-negative.
- A third of actual influenza patients received an antiviral, while half were treated with antibiotics.
Certainly not a paragon of medical prowess.
The authors, unfortunately, use their data as a platform for wickedness. In the context of inadequate diagnostic skill, the authors call for improved rapid diagnostic tools – such as those manufactured by the study sponsor. Furthermore, the entire need for such rapid tools is predicated on the assumption of benefit from antiviral therapy – which is also espoused by the authors, who have undeclared ROI with Roche.
“Clinical diagnosis of influenza in the ED”
http://www.ncbi.nlm.nih.gov/pubmed/25827595
Dude,
"platform for wickedness"
I live your style!