Promising results for rapid viral diagnosis tests in emergency rooms

5 October 2009

Rapid viral diagnosis tests for respiratory diseases in children who arrive in emergency departments have the potential to reduce pressures on health systems by enabling doctors to reach a quicker diagnosis, according to Cochrane Researchers. However, they say larger trials are needed to confirm this finding.

“The existing evidence is not strong enough to prove that these tests help to reduce pressure on health systems, but it certainly does look promising,” said lead researcher, Quynh Doan of the British Columbia Children’s Hospital in Vancouver, Canada.

Children who are admitted to emergency departments with cold and flu symptoms and fever undergo various diagnostic tests and are often prescribed antibiotics as a precautionary measure, even though viruses, which are often the cause, do not respond to antibiotics.

The burden on health systems is huge, not only financially, but also in terms of the time and staff required to reach a diagnosis. Rapid viral diagnosis methods could help deliver fast, accurate diagnoses, and enable a much more appropriate use of antibiotics.

The study included data from four trials, which together included 1,588 children. There was some evidence that rapid viral testing reduced use of other blood or urine tests, chest X-rays and antibiotics, but the results were not significant. However, the researchers suggest that further, sufficiently large studies could reveal the true impact of faster tests.

“A large controlled trial would help us to understand whether rapid viral testing can be of any great benefit,” says Doan. “For example, we saw a weak trend towards reduced antibiotic prescriptions, but results were contradictory between the different trials. It would also be interesting to see some evaluation of cost effectiveness for these more rapid tests.”

Reference

1. Doan Q, Enarson P, Kissoon N, Klassen TP, Johnson DW. Rapid viral diagnosis for acute febrile respiratory illness in children in the Emergency Department. Cochrane Database of Systematic Reviews 2009, Issue 4.Art.No.: CD006452. DOI: 10.1002/14651858.CD006452.pub2.

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