Use of rapid influenza diagnostic tests under field conditions as a screening tool during an outbreak of the 2009 novel influenza virus: Practical considerations

Anthony R. Sambol, Baha Abdalhamid, Elizabeth R. Lyden, Tricia A. Aden, Rhonda K. Noel, Steven Heye Hinrichs

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Background: Rapid influenza diagnostic tests (RIDTs) are used in various settings as a first-line screen of patient specimens. During the initial outbreak of the 2009 novel influenza A/H1N1 virus, the Nebraska Public Health Laboratory (NPHL) adopted a testing algorithm, attempting to maximize the usefulness of RIDTs. However, it became apparent that a high percentage of the positive specimens received from off-site facilities were negative for influenza viruses by the confirmatory test, the Luminex xTAG Respiratory Viral Panel (RVP) molecular assay. Objectives: To explore the cause of discrepancies between RIDTs results obtained from on-site facility testing versus confirmatory testing performed at NPHL. Study design: Specimens (n = 336) tested with RIDTs at off-site facilities and screened for high-probability of containing H1N1 were sent to the NPHL for confirmatory testing by RVP. Results: Of 336 specimens analyzed, 104 were negative for influenza A or B by both RIDT and RVP; 127 were positive by both tests; 102 were positive by RIDT only; and 3 were positive by RVP only. Using the RVP assay as the gold standard, overall RIDT characteristics in this screened population were: sensitivity = 97.7% (95%CI: 92.5, 99.3); specificity = 48.1% (95%CI: 40.4, 55.8); positive predictive value = 54.3% (95%CI: 47.0, 61.4); and negative predicative value = 97.1% (95%CI: 90.6, 99.1). Conclusions: The results show that the confirmation of RIDT-positive results varied widely by testing site. Possible explanations for the discrepancies in performance characteristics include testing a narrowly defined sample population, test facility characteristics, facility work load, and seasonal timing.

Original languageEnglish (US)
Pages (from-to)229-233
Number of pages5
JournalJournal of Clinical Virology
Volume47
Issue number3
DOIs
StatePublished - Mar 1 2010

Fingerprint

Orthomyxoviridae
Routine Diagnostic Tests
Human Influenza
Disease Outbreaks
Public Health
H1N1 Subtype Influenza A Virus
Influenza A virus
Workload
Population

Keywords

  • BinaxNOW
  • Luminex RVP
  • QuickVue
  • RIDT
  • Sensitivity
  • Specificity
  • TruFlu
  • Xpect

ASJC Scopus subject areas

  • Virology
  • Infectious Diseases

Cite this

Use of rapid influenza diagnostic tests under field conditions as a screening tool during an outbreak of the 2009 novel influenza virus : Practical considerations. / Sambol, Anthony R.; Abdalhamid, Baha; Lyden, Elizabeth R.; Aden, Tricia A.; Noel, Rhonda K.; Hinrichs, Steven Heye.

In: Journal of Clinical Virology, Vol. 47, No. 3, 01.03.2010, p. 229-233.

Research output: Contribution to journalArticle

@article{d18d7ea7cd0a4900b7d878c80bcdc5e5,
title = "Use of rapid influenza diagnostic tests under field conditions as a screening tool during an outbreak of the 2009 novel influenza virus: Practical considerations",
abstract = "Background: Rapid influenza diagnostic tests (RIDTs) are used in various settings as a first-line screen of patient specimens. During the initial outbreak of the 2009 novel influenza A/H1N1 virus, the Nebraska Public Health Laboratory (NPHL) adopted a testing algorithm, attempting to maximize the usefulness of RIDTs. However, it became apparent that a high percentage of the positive specimens received from off-site facilities were negative for influenza viruses by the confirmatory test, the Luminex xTAG Respiratory Viral Panel (RVP) molecular assay. Objectives: To explore the cause of discrepancies between RIDTs results obtained from on-site facility testing versus confirmatory testing performed at NPHL. Study design: Specimens (n = 336) tested with RIDTs at off-site facilities and screened for high-probability of containing H1N1 were sent to the NPHL for confirmatory testing by RVP. Results: Of 336 specimens analyzed, 104 were negative for influenza A or B by both RIDT and RVP; 127 were positive by both tests; 102 were positive by RIDT only; and 3 were positive by RVP only. Using the RVP assay as the gold standard, overall RIDT characteristics in this screened population were: sensitivity = 97.7{\%} (95{\%}CI: 92.5, 99.3); specificity = 48.1{\%} (95{\%}CI: 40.4, 55.8); positive predictive value = 54.3{\%} (95{\%}CI: 47.0, 61.4); and negative predicative value = 97.1{\%} (95{\%}CI: 90.6, 99.1). Conclusions: The results show that the confirmation of RIDT-positive results varied widely by testing site. Possible explanations for the discrepancies in performance characteristics include testing a narrowly defined sample population, test facility characteristics, facility work load, and seasonal timing.",
keywords = "BinaxNOW, Luminex RVP, QuickVue, RIDT, Sensitivity, Specificity, TruFlu, Xpect",
author = "Sambol, {Anthony R.} and Baha Abdalhamid and Lyden, {Elizabeth R.} and Aden, {Tricia A.} and Noel, {Rhonda K.} and Hinrichs, {Steven Heye}",
year = "2010",
month = "3",
day = "1",
doi = "10.1016/j.jcv.2009.12.015",
language = "English (US)",
volume = "47",
pages = "229--233",
journal = "Journal of Clinical Virology",
issn = "1386-6532",
publisher = "Elsevier",
number = "3",

}

TY - JOUR

T1 - Use of rapid influenza diagnostic tests under field conditions as a screening tool during an outbreak of the 2009 novel influenza virus

T2 - Practical considerations

AU - Sambol, Anthony R.

AU - Abdalhamid, Baha

AU - Lyden, Elizabeth R.

AU - Aden, Tricia A.

AU - Noel, Rhonda K.

AU - Hinrichs, Steven Heye

PY - 2010/3/1

Y1 - 2010/3/1

N2 - Background: Rapid influenza diagnostic tests (RIDTs) are used in various settings as a first-line screen of patient specimens. During the initial outbreak of the 2009 novel influenza A/H1N1 virus, the Nebraska Public Health Laboratory (NPHL) adopted a testing algorithm, attempting to maximize the usefulness of RIDTs. However, it became apparent that a high percentage of the positive specimens received from off-site facilities were negative for influenza viruses by the confirmatory test, the Luminex xTAG Respiratory Viral Panel (RVP) molecular assay. Objectives: To explore the cause of discrepancies between RIDTs results obtained from on-site facility testing versus confirmatory testing performed at NPHL. Study design: Specimens (n = 336) tested with RIDTs at off-site facilities and screened for high-probability of containing H1N1 were sent to the NPHL for confirmatory testing by RVP. Results: Of 336 specimens analyzed, 104 were negative for influenza A or B by both RIDT and RVP; 127 were positive by both tests; 102 were positive by RIDT only; and 3 were positive by RVP only. Using the RVP assay as the gold standard, overall RIDT characteristics in this screened population were: sensitivity = 97.7% (95%CI: 92.5, 99.3); specificity = 48.1% (95%CI: 40.4, 55.8); positive predictive value = 54.3% (95%CI: 47.0, 61.4); and negative predicative value = 97.1% (95%CI: 90.6, 99.1). Conclusions: The results show that the confirmation of RIDT-positive results varied widely by testing site. Possible explanations for the discrepancies in performance characteristics include testing a narrowly defined sample population, test facility characteristics, facility work load, and seasonal timing.

AB - Background: Rapid influenza diagnostic tests (RIDTs) are used in various settings as a first-line screen of patient specimens. During the initial outbreak of the 2009 novel influenza A/H1N1 virus, the Nebraska Public Health Laboratory (NPHL) adopted a testing algorithm, attempting to maximize the usefulness of RIDTs. However, it became apparent that a high percentage of the positive specimens received from off-site facilities were negative for influenza viruses by the confirmatory test, the Luminex xTAG Respiratory Viral Panel (RVP) molecular assay. Objectives: To explore the cause of discrepancies between RIDTs results obtained from on-site facility testing versus confirmatory testing performed at NPHL. Study design: Specimens (n = 336) tested with RIDTs at off-site facilities and screened for high-probability of containing H1N1 were sent to the NPHL for confirmatory testing by RVP. Results: Of 336 specimens analyzed, 104 were negative for influenza A or B by both RIDT and RVP; 127 were positive by both tests; 102 were positive by RIDT only; and 3 were positive by RVP only. Using the RVP assay as the gold standard, overall RIDT characteristics in this screened population were: sensitivity = 97.7% (95%CI: 92.5, 99.3); specificity = 48.1% (95%CI: 40.4, 55.8); positive predictive value = 54.3% (95%CI: 47.0, 61.4); and negative predicative value = 97.1% (95%CI: 90.6, 99.1). Conclusions: The results show that the confirmation of RIDT-positive results varied widely by testing site. Possible explanations for the discrepancies in performance characteristics include testing a narrowly defined sample population, test facility characteristics, facility work load, and seasonal timing.

KW - BinaxNOW

KW - Luminex RVP

KW - QuickVue

KW - RIDT

KW - Sensitivity

KW - Specificity

KW - TruFlu

KW - Xpect

UR - http://www.scopus.com/inward/record.url?scp=76449087173&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=76449087173&partnerID=8YFLogxK

U2 - 10.1016/j.jcv.2009.12.015

DO - 10.1016/j.jcv.2009.12.015

M3 - Article

C2 - 20080438

AN - SCOPUS:76449087173

VL - 47

SP - 229

EP - 233

JO - Journal of Clinical Virology

JF - Journal of Clinical Virology

SN - 1386-6532

IS - 3

ER -