Clinical prediction of laboratory-confirmed influenza in adults with influenza-like illness in primary care. A randomized controlled trial secondary analysis in 15 European countries.

Autor:	Ouchi D; University Institute in Primary Care Research Jordi Gol i Gurina, Barcelona, Spain.; Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain., García-Sangenís A; University Institute in Primary Care Research Jordi Gol i Gurina, Barcelona, Spain., Moragas A; University Institute in Primary Care Research Jordi Gol i Gurina, Barcelona, Spain., van der Velden AW; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands., Verheij TJ; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands., Butler CC; Nuffield Department of Primary Health Care Sciences, University of Oxford, Oxford, United Kingdom., Bongard E; Nuffield Department of Primary Health Care Sciences, University of Oxford, Oxford, United Kingdom., Coenen S; Centre for General Practice, Department of Family Medicine & Population Health, University of Antwerp, Antwerp, Belgium., Cook J; Nuffield Department of Primary Health Care Sciences, University of Oxford, Oxford, United Kingdom., Francis NA; Primary Care Research Centre, University of Southampton, Southampton,United Kingdom., Godycki-Cwirko M; Centre for Family and Community Medicine, Faculty of Health Sciences, Medical University of Lodz, Lodz, Poland., Lundgren PT; Département de Santé Publique, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Nice, France., Lionis C; Clinic of Social and Family Medicine, Faculty of Medicine, University of Crete, Crete, Greece., Radzeviciene Jurgute R; JSC Mano Seimos Gydytojas (My Family Doctor), Klaipeda, Lithuania., Chlabicz S; Department of Family Medicine, Medical University of Bialystok, Bialystok, Poland., De Sutter A; Centre for Family Medicine UGent, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium., Bucher HC; Basel Institute for Clinical Epidemiology and Biostatistics, Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland., Seifert B; Department of General Practice, First Faculty of Medicine, Charles University, Prague, Czech Republic., Kovács B; Drug Research Centre, Balatonfüred, Hungary., de Paor M; HRB Centre for Primary Care Research, Department of General Practice, Royal College of Surgeons in Ireland (RCSI), Health Research Board Primary Care Clinical Trial Network Ireland, National University of Ireland Galway, Galway, Ireland., Sundvall PD; Research, Education, Development & Innovation Primary Health Care, Region Västra Götaland and Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden., Aabenhus R; Section and Research Unit of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark., Harbin NJ; Antibiotic Centre for Primary Care, Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway., Ieven G; Laboratory of Clinical Microbiology, Antwerp, University Hospital, Edegem, Belgium., Goossens H; Laboratory of Clinical Microbiology, Antwerp, University Hospital, Edegem, Belgium., Lindbæk M; Antibiotic Centre for Primary Care, Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway., Bjerrum L; Section and Research Unit of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark., Llor C; University Institute in Primary Care Research Jordi Gol i Gurina, Barcelona, Spain.; Department of Public Health, General Practice, University of Southern Denmark, Odense, Denmark.
Jazyk:	angličtina
Zdroj:	Family practice [Fam Pract] 2022 May 28; Vol. 39 (3), pp. 398-405.
DOI:	10.1093/fampra/cmab122
Abstrakt:	Background: Clinical findings do not accurately predict laboratory diagnosis of influenza. Early identification of influenza is considered useful for proper management decisions in primary care. Objective: We evaluated the diagnostic value of the presence and the severity of symptoms for the diagnosis of laboratory-confirmed influenza infection among adults presenting with influenza-like illness (ILI) in primary care. Methods: Secondary analysis of patients with ILI who participated in a clinical trial from 2015 to 2018 in 15 European countries. Patients rated signs and symptoms as absent, minor, moderate, or major problem. A nasopharyngeal swab was taken for microbiological identification of influenza and other microorganisms. Models were generated considering (i) the presence of individual symptoms and (ii) the severity rating of symptoms. Results: A total of 2,639 patients aged 18 or older were included in the analysis. The mean age was 41.8 ± 14.7 years, and 1,099 were men (42.1%). Influenza was microbiologically confirmed in 1,337 patients (51.1%). The area under the curve (AUC) of the model for the presence of any of seven symptoms for detecting influenza was 0.66 (95% confidence interval [CI]: 0.65-0.68), whereas the AUC of the symptom severity model, which included eight variables-cough, fever, muscle aches, sweating and/or chills, moderate to severe overall disease, age, abdominal pain, and sore throat-was 0.70 (95% CI: 0.69-0.72). Conclusion: Clinical prediction of microbiologically confirmed influenza in adults with ILI is slightly more accurate when based on patient reported symptom severity than when based on the presence or absence of symptoms. (© The Author(s) 2021. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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