DynaMed Weekly Update

August 11, 2009

Volume 4 Issue 32

DynaMed Systematic Literature Surveillance

For the week ending August 7, 2009

This week, 791 articles were considered for inclusion in DynaMed and 315 met criteria for inclusion.

Based on the criteria of selecting “articles most likely to change clinical practice,” one article of significant interest is included in this weekly update.

Rapid Influenza Diagnostic Tests Appear to Have Low Overall Sensitivity for Detecting Pandemic (H1N1) 2009

Three rapid influenza tests appear to have low overall sensitivity for detection of pandemic (H1N1) 2009. Sixty-five respiratory specimens, which previously tested positive for pandemic (H1N1) 2009, were tested again with three rapid influenza diagnostic tests. Detection of pandemic (H1N1) 2009 ranged from 40%-69% overall. Higher sensitivity was reported for seasonal flu (60%-83%), but the evidence is limited due to a small sample size (MMWR Morb Mortal Wkly Rep 2009 Aug 7;58(30):826 full-text).

According to the US Centers for Disease Control and Prevention (CDC) Interim Guidance for the Detection of Novel Influenza A Virus using Rapid Influenza Diagnostic Tests (CDC 2009 Aug 10), the rapid tests may be helpful to guide clinical decisions at the point of care. If influenza virus is active in the community, a positive test suggests presence of that viral infection. Some tests can distinguish between influenza A and B, but rapid influenza diagnostic tests cannot distinguish between seasonal influenza and pandemic influenza (H1N1) 2009. A negative test does NOT rule out influenza and should not be used to guide clinical decisions. If clinical suspicion is high, appropriate empiric therapy should be started. Confirmatory tests should also be ordered if appropriate. The CDC also warns clinicians to NOT use a negative test to send a child back to school, rule out an institutional outbreak, or decide infection control measures.

For more information, see the Pandemic (H1N1) 2009 topic in DynaMed.

For the latest evidence-based influenza-related information available for free, visit www.ebscohost.com/flu.

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DynaMed Topic Activity

New summaries added to DynaMed this week:

· Fever without apparent source in critically ill adults

· Fever without apparent source in long-term care residents

DynaMed Peer Review

We are currently seeking reviewers for:

· Heat cramps

· Heat exhaustion

· Heatstroke

For more information, see Editorial Policies for Authors & Reviewers and DynaMed Peer Review.

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DynaMed Weekly Update Archives

DynaMed Weekly Update is a compilation of 1 to 5 articles that are of significant interest to clinicians. Articles are selected from DynaMed's Systematic Literature Surveillance as articles most likely to change clinical practice. Updates are prepared by the DynaMed Editorial Team which includes 28 clinicians from multiple disciplines. Send comments to DynaMedEditor@epnet.com. To learn more about DynaMed, go to www.dynamicmedical.com.

Published by DynaMed
Copyright © 2009 EBSCO Publishing. All rights reserved.
DynaMed® is a registered trademark of and published by DynaMed LLC. Original date of on-line publication December 15, 1995 with continuous daily updating. ISSN: 1554-1177. Subscriptions and queries can be addressed to DynaMed LLC, EBSCO Publishing, 10 Estes St., Ipswich, Massachusetts, USA 01938-0602, telephone (978) 356-6500, facsimile (978) 356-6565, e-mail Editor@DynamicMedical.com. The opinions expressed herein are solely those of the authors and editors and may or may not represent the official position of cooperating or endorsing Medical Societies. Development of DynaMed was supported in part by the National Science Foundation through a Small Business Innovative Research grant. (All other support comes from subscriptions. No advertisements are accepted.)