Evaluation of clinical case definitions of influenza: Detailed investigation of patients during the 1995-1996 epidemic in France
Evaluation of clinical case definitions of influenza: Detailed investigation of patients during the 1995-1996 epidemic in France
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DOI：
10.1086/515117
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发表时间：
1999-02-01
影响因子：
11.8
通讯作者：
Valleron, AJ
中科院分区：
文献类型：
--
作者：
Carrat, F;Tachet, A;Valleron, AJ
使用临床预测因子，我们评估了1995-1996年法国流感暴发期间流感的临床病例定义。35名全科医生收集了病毒学标本和临床数据。流感病毒感染的预测因子采用逻辑回归模型进行筛选。结果因流感病毒亚型而异：体温>38.2 ℃、僵硬或肌痛、流涕和咳嗽可预测甲型H3 N2流感，而疲劳、流泪或结膜充血、无僵硬或肌痛可预测甲型H1N1流感。根据这一分析和文献数据，评价了12种临床病例定义诊断流感病毒感染的能力。它们与27%至40%的阳性预测值和80%至91%的阴性预测值相关。我们的结论是，重点研究评估流感的临床病例定义与使用患者的子集，应伴随以人群为基础的疾病监测与流感流行相关的疾病负担的最佳估计。
Using clinical predictors, we evaluated clinical case definitions of influenza during the 1995-1996 outbreak in France. Thirty-five general practitioners collected virological specimens and clinical data. Predictors of influenza virus infection were selected with logistic regression models. The results varied with the influenza virus subtype: temperature of >38.2 degrees C, stiffness or myalgia, rhinorrhea, and cough were predictive of influenza A/H3N2, whereas fatigue, lacrimation or conjunctival injection, and the absence of stiffness or myalgia were predictive of influenza A/H1N1. On the basis of this analysis and data from the literature, 12 clinical case definitions were evaluated for their abilities to diagnose influenza virus infection. They were associated with positive predictive values of 27% to 40% and negative predictive values of 80% to 91%. We conclude that focused studies evaluating clinical case definitions of influenza with use of subsets of patients should accompany population-based disease surveillance for optimal estimates of the disease burden associated with influenza epidemics.