Accuracy and Discomfort of Different Types of Intranasal Specimen Collection Methods for Molecular Influenza Testing in Emergency Department Patients

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Presentation transcript:

Accuracy and Discomfort of Different Types of Intranasal Specimen Collection Methods for Molecular Influenza Testing in Emergency Department Patients Bradley W. Frazee, MD, Amparo Rodríguez-Hoces de la Guardia, PhD, Harrison Alter, MD, MS, Carol G. Chen, PhD, Eugenia L. Fuentes, MSc, Alison K. Holzer, PhD, Macarena Lolas, MD, PhD, Debkishore Mitra, PhD, Jaspreet Vohra, MD, Cornelia L. Dekker, MD Annals of Emergency Medicine Volume 71, Issue 4, Pages 509-517.e1 (April 2018) DOI: 10.1016/j.annemergmed.2017.09.010 Copyright © 2017 American College of Emergency Physicians Terms and Conditions

Figure 1 Specimen collection methods. A, Specimen collection swabs. Copan midturbinate adult flocked swab (A). Copan flexible nasopharyngeal flocked swab (B). Puritan sterile foam swab (C). Swab type B was used for both nasopharyngeal and nasal collection in California; swab type C was used for nasal collection in Chile. B, Sampling locations. NPS, Nasopharyngeal swab; MTS, midturbinate swab; NS, nasal swab. Annals of Emergency Medicine 2018 71, 509-517.e1DOI: (10.1016/j.annemergmed.2017.09.010) Copyright © 2017 American College of Emergency Physicians Terms and Conditions

Figure 2 Study flow diagram. Annals of Emergency Medicine 2018 71, 509-517.e1DOI: (10.1016/j.annemergmed.2017.09.010) Copyright © 2017 American College of Emergency Physicians Terms and Conditions

Figure 3 Discomfort scores (N=483*). Discomfort was assessed on a 6-point Faces Pain Scale, from 0 to 5. *There were 483 subjects in this analysis because one subject missing a discomfort score was excluded. Annals of Emergency Medicine 2018 71, 509-517.e1DOI: (10.1016/j.annemergmed.2017.09.010) Copyright © 2017 American College of Emergency Physicians Terms and Conditions

Figure E1 Analysis of clustering by hospital site. Forest plots showing results of the ROC analysis that assessed for clustering of test performance by hospital site. The AUC value for each site (boxes) is compared with that of the overall cohort (diamonds). Sizes of the boxes are proportional to the number of subjects enrolled at the site, or weight. The number of subjects at each hospital site was A=49, B=95, C=279, and D=59. The point estimates for hospital A lie outside the 95% CI of the overall cohort value, indicating that there was clustering. LCL, Lower confidence limit; UCL, upper confidence limit; WGHT, weight. Annals of Emergency Medicine 2018 71, 509-517.e1DOI: (10.1016/j.annemergmed.2017.09.010) Copyright © 2017 American College of Emergency Physicians Terms and Conditions