IMPROVING RAPID INFLUENZA TESTING
WITH AN EDUCATIONAL WEBSITE
By Dr. Pete Shult, PhD, Wisconsin Laboratory of Hygiene, and Dr. Laurina Williams, PhD, MPH, CDC
Rapid influenza diagnostic tests (RIDTs), which are immunoas- says that can identify the presence of influenza A and B in respiratory specimens, have become a diagnostic mainstay in
clinical laboratories and point-of-care settings. These tests often play
a key role in clinical decisions in the ambulatory care setting when
performed and interpreted correctly.
There are a number of RIDTs available commercially that can yield
results in a cost-effective and clinically relevant time frame, i.e.,
approximately 15 minutes or less. However, RIDTs are shown to have
limited sensitivity to detect influenza virus infection; negative test
results need to be interpreted with caution given the potential for
false negative results. In addition, the test result needs to be
interpreted in the context of influenza activity within the
community to avoid the possibility of false positive results. The
optimal utility of these tests thus relies on the user’s ability to
understand the performance limitations of the various RIDTs and
the impact of influenza strains circulating in the population. RIDT
usage can be further optimized by recognizing the type of respiratory
specimens required and understanding how to collect high quality
specimens and handle them properly.
To enhance the understanding of the proper use and interpretation
of these tests among healthcare practitioners, The Joint Commis-
sion (TJC), through a cooperative agreement with CDC, surveyed US
outpatient healthcare providers about the use of RIDTs and antiviral
prescription practices during the 2008 (pre-H1N1) and 2010
(post-H1N1) periods. Clinicians in outpatient facilities used RIDT
findings to aid in treatment decisions in both time periods, with the
2009 H1N1 pandemic influencing increased use of RIDTs. In col-
laboration with the College of American Pathologists (CAP), clinical
laboratories were also later surveyed. CDC and TJC worked with a
Technical Advisory Panel (TAP) of partners representing professional
organizations, including Dr. Pete Shult, APHL’s Influenza Subcommit-
tee Chair, to develop the surveys; and then, using the survey results,
to design a free, web-based education course for healthcare provid-
ers using RIDTs. The course, “Strategies for Improving Influenza
Rapid Testing in Ambulatory Settings,” or “SIRAS,” provides guidance
for the appropriate use of RIDT in the diagnosis and treatment of
influenza, demonstrates proper techniques for collecting respiratory
specimens, and reviews information pertinent to accurate
performance of point-of-care testing.
The SIRAS course consists of two, free training modules—one on
RIDT usage, appropriate for health care professionals and another, a
series of videos on specimen collection, for anyone who is collecting
specimens for RIDTs and other respiratory diagnostic test methods.
[See sidebar.]
This module offers 2.0 hours of CEs (ACCME, ANCC) issued by Joint
Commission Resources (JCR). Registration is available at www.joint-commission.org/siras.aspx. In addition, the SIRAS website provides
direct links to a number of valuable resources and relevant
influenza-related websites.
Since the launch of the SIRAS website in October 2012, results
indicate a high level of usage and satisfaction with course content
by a variety of healthcare practitioners. These results will be
highlighted in posters at the 2013 APHL Annual Meeting.
This resource, with its highly accessible and updatable formats, will
ideally go a long way in improving the diagnosis and treatment of
patients with influenza, much to the benefit of public health. u
FREE
ONLINE
COURSE
