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Rapid PCR superior in detecting influenza among children in ED
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Rapid multiplex PCR was the most costly, yet effective strategy for detecting influenza among a cohort of children aged 3 months to 18 years presenting to an ED with influenza-like illness, according to results of a decision analytic model.
“Rapid multiplex PCR testing is associated with significant cost but one that is within the threshold for adopting new cost-effective technologies,” Richard E. Nelson, PhD, of Salt Lake City Veterans Affairs Health Care System, and colleagues wrote. “If the costs of rapid multiplex PCR are lowered and the benefits of detecting other respiratory pathogens can be confirmed, the cost-effectiveness would become even more favorable.”
Nelson and colleagues developed a decision analytic model and compared the cost-effectiveness of four diagnostic methods — rapid multiplex PCR platform (FilmArray; BioFire Diagnostics), traditional PCR, direct-fluorescent antibody (Simufluor; Light Diagnostics) and rapid antigen tests (QuickVue Influenza A + B Test; Quidel) — in detecting influenza among children presenting to the ED with influenza-like illness. Children were divided by age: 3 months to 36 months and 3 years to 18 years.
According to study results, the most effective testing strategy across both age groups was rapid multiplex PCR. When compared with rapid antigen tests, the incremental cost-effectiveness was $115,556 per quality-adjusted life years (QALY) for children aged 3 to 36 months vs. $228,000 per QALY for children aged 3 to18 years.
While the most significant number of true cases was detected with traditional singleplex PCR (n = 294), results were available only after the 24-hour turnaround time. Conversely, the 285 cases that were detected by rapid multiplex PCR testing strategy and the 186 cases detected by rapid antigen testing were identified at point of care, allowing the information to be incorporated into patient care decision making, according to the researchers. – by Jennifer Southall
Disclosure: Nelson reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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