Table 1.
Included studies assessing antiviral prescriptiona
| Authors, Year, Location | Population, Study Period, Patient Groups | POCT | Results |
|---|---|---|---|
| Brendish et al, 2017,16 UK16, b | A RCT enrolling 720 adults (>18 years) with acute respiratory illness at a large UK hospital during Jan‐July 2015, and Oct 2015‐April 2016. Patients randomly assigned either POCT (n = 362) or routine care (n = 358). | FilmArray Respiratory Panel | Significant, POCT+ vs standard+: 52/57 (91%) vs 24/37 (65%), P = 0.0026 |
| Nitsch‐Osuch et al, 2017,17 Polandb | A study comparing treatment of hospitalised children in a paediatric ward during two consecutive influenza seasons: Jan‐Mar 2015, when no RIDT were in use (n = 52), and Jan‐march 2016, when RIDT were implemented into routine practice (n = 63). | bioNexia Influenza A+B | Significant, POCT+ vs standard+: 7/11 (64%) vs 0/15 (0%), P < 0.05 |
| Trabattoni et al, 2017,24 Franceb , c | A single centre prospective observational study comparing two diagnostic strategies over 2 months. During Feb 2016 standard laboratory testing was used for diagnosis of influenza (n = 169), and in Mar 2016, a POCT was performed (n = 132). | Alere i Influenza A&B | Not significant, POCT vs standard: 7/132 (5.3%) vs 4/169 (2.4%), P = 0.22 |
| Li‐Kim‐Moy et al, 2016,18 Australiab , c | A retrospective review of 364 lab‐confirmed influenza cases presenting at a paediatric ED during Jan‐Dec 2009. Children (<18 y) were diagnosed with influenza by either POCT (n = 236) or standard testing (n = 65). | QuikVue Influenza A+B | Significant, POCT+ vs standard+: 109/236 (46.2%) vs 14/65 (21.5%), P = 0.001 |
| Chu et al, 2015,30 USAb | A retrospective study of 350 adult (>18 y) patients at a teaching hospital and medical centre in USA over two influenza seasons, Feb–Mar 2012 and January 2013. The first season was prior to implementation of POCT (n = 175) and in the second season POCT was used systematically (n = 175). | Simplexa Flu A/B & RSV Kit | Significant, pre‐POCT vs post‐POCT: 79/175 (45%) vs 97/175 (55%), P = 0.05 |
| González‐Del Vecchio et al, 2015,39 Spainb | Cohort of 217 children and adults influenza positive from a general teaching hospital in Spain over one influenza season, Jan–Mar 2014. Patients were divided into: A‐POCT negative, reference positive (n = 132) or B‐POCT positive (n = 85) | Xpect Flu A&B | Significant, A vs B: 89/132 (67.4%) vs 70/85 (82.3%), P = 0.02 |
| Blaschke et al, 2014,19 USAb , d | A retrospective study using data from the National Hospital Ambulatory Medical Care Survey over three influenza periods: Jan‐Apr 2007, Oct‐Dec 2008, and Jan‐Apr 2009. 1166 of an estimated 4.9 M eligible ED visits were sampled and examined in three groups: POCT+, POCT−, and Influenza (+) by standard test. | Not specified | Significant, POCT+ vs standard+: 56% vs 19%, P = 0.002Significant, POCT+ vs POCT−: 56% vs 2%, P < 0.0001 |
| Lim et al, 2014,23 Koreab | A retrospective review of medical records of 770 children (<15 y) hospitalised with laboratory confirmed influenza between Feb 2004 and June 2007. Different treatment groups were analysed and included patients receiving; oseltamivir only (n = 27), antibiotics‐only (n = 620), antibiotics/oseltamivir combination (n = 67), or standard supportive care (n = 56). | Directigen EZ Flu A+B Test Kit | Significant, oseltamivir only vs antibiotics only, antibiotics/oseltamivir combination, standard supportive care: likelihood of diagnosis by POCT− 22/27 (81.5%) vs 21/620 (3.4%) P < 0.001, 37/67 (55.2%) P = 0.017, 9/56 (16.1%) P < 0.001 |
| Suryaprasad et al, 2014,21 USA | A retrospective analysis of patients with ILI who presented to four US healthcare facilities during the May‐Dec 2009 period. A POCT was performed on 290 subjects within 48 h of symptom onset. | BinaxNOW® influenza A & B | Significant, POCT+ vs POCT−: 48/84 (57%) vs 37/206 (18%) (rate ratio 3.3, 95% CI 2.4, 4.6) |
| Theocharis et al, 2010,22 Greeceb | An observational study of patients with ILI who received house call visits from a network of doctors in Greece during Jan‐May 2009. 3412 visits were due to ILI, 184 of which had data available from a POCT. | Coris BioConcept Influ A&B Uni‐Strip | Significant, POCT+ vs POCT−: 74/97 (76.2%) vs 1/87 (1.1%), P < 0.01 |
| Jennings et al, 2009,20 Germanyb | A study analysing data from a standardised questionnaire that was used by paediatricians in Germany assessing children 1‐12 y with ILI. During the study period Jan‐April 2007, 16 907 patients were evaluated, 15 871 of which received a POCT. | Clearview Exact Influenza A+B | Significant, POCT+ vs standard+: 4618/7658 (60.1%) vs 178/725 (24.6%) |
| Falsey et al, 2007,37 USAb | Retrospective analysis of 166 adult (>18 y) hospitalised patients at a hospital in USA over four influenza seasons, Nov‐Apr 1999‐2003. Comparison of POCT positive (n = 86) and POCT negative/no POCT (n = 80) | Directigen Test Kit | Significant, POCT+ vs POCT−/no test: 63/86 (73%) vs 6/80 (8%), P < 0.001 |
| Poehling et al, 2006,25 USAb | A RCT enrolling children <5 y presenting with ILI in a Tennessee county over two consecutive influenza seasons (2003‐2004). All subjects (n = 468) had a nasal and throat swab obtained for PCR, and surveillance days were randomised to perform POCT (n = 205). | Quikvue influenza test | Not significant, POCT vs standard: 1/205 (0.5%) vs 0/263 (0%) |
| Bonner et al, 2003,31 USAb | An RCT of patients aged 2 mo to 21 y at a children's teaching hospital ED in USA over one influenza season, Jan‐Mar 2002. All patients (n = 391) received a POCT. Of 202 influenza positive patients, the physician was either made aware of the result (n = 96) or unaware (n = 106). | Flu OIA® | Significant, aware vs unaware: 18/96 (18.8%) vs 7/106 (6.6%), P < 0.02 |
Abbreviations: ED, emergency department; ILI, influenza‐like illness; POCT, point of care tests; RCT, randomised controlled trial; RIDT, rapid influenza diagnostic test.
a
Listed by year of publication, alphabetical.
b
Also assessed antibiotic prescription (Table 2).
c
Also assessed ED length of stay (Table 3).
d
Reported as weighted percentages, exact numbers not available.