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Rapid Diagnosis of Respiratory Diseases in Emergency Rooms
Rapid viral diagnosis tests for respiratory diseases in children who arrive in emergency departments (EDs) have the potential to reduce pressures on health systems by enabling doctors to reach a quicker diagnosis, according to a new study.
Researchers at the British Columbia Children's Hospital (Vancouver, BC, Canada) conducted a review of studies that included data from four trials, which together included 1,588 children, to determine the effect of rapid viral testing in the ED on the rate of precautionary testing, antibiotic use, and ED length of visit. The researchers found that in fact, rapid viral testing did not reduce antibiotic use in the ED significantly, neither clinically nor statistically. The researchers did find lower rates of chest radiography in the rapid viral testing group, but no effect on length of ED visits, blood or urine testing. The researchers suggest that further, sufficiently large studies could reveal the true impact of faster tests. The study was published in the October 2009 issue of Cochrane Database of Systematic Reviews.
“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, M.D. “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.”
Children who are admitted to EDs with cold or flu symptoms as well as fever undergo various diagnostic tests and they 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.