Assessment and comparison of the ILI case definition in clinical and school-based community settings: ORCHARDS/IISP.

IF 4.4 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Annals of Family Medicine Pub Date : 2024-11-01 DOI:10.1370/afm.22.s1.4842
Angela Lii, Jonathan Temte, Shari Barlow, Maureen Goss, Emily Temte, Jen Zaborek, Amra Uzicanin
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Abstract

Context: Influenza-like illness (ILI) is commonly used in clinical and public health settings to identify influenza cases. CDC defines ILI as fever and either cough or sore throat, with symptom onset within 7 days. Objective: Assess performance of ILI criteria in two settings (clinical and community), comparing symptom profiles and laboratory detection of influenza in children. Study Design and Analysis: Retrospective analyses of data from medically attended influenza (MAI) surveillance and a communitybased study. Datasets were analyzed separately to assess predictors of influenza cases. Analyses were limited to specimens collected within 7 days of symptom onset. Relationships between influenza and each categorical variable were described by the confusion matrix, sensitivity, and specificity. Associations were tested using chi-square tests. Unadjusted and adjusted logistic regression models were used for all variables with RT-PCR result as the outcome. Setting or Dataset: The ORegon CHild Absenteeism due to Respiratory Disease Study (ORCHARDS) is a respiratory infection study based in the Oregon School District (Dane County, WI). The Wisconsin Influenza Incidence Surveillance Project (IISP) is a MAI surveillance system operating in five family medicine clinics in Dane County. Population Studied: Children aged 4-18 years with acute respiratory infections. Intervention/Instrument: Oropharyngeal specimens, collected by research staff (ORCHARDS) or clinicians (IISP), were tested for influenza via RT-PCR and for multiple respiratory viruses at the Wisconsin State Laboratory of Hygiene. Extensive demographic and symptoms data were collected from all participants. Outcome Measures: Influenza(+)PCR. Results: From 9/7/2010-3/12/2020, 1,338 and 2,359 specimens meeting inclusion criteria were collected for IISP and ORCHARDS, respectively. Cough, fever, and ILI classification were significantly associated with influenza (sensitivity ≥92.8%, ≥85.9%, and ≥84.5%, respectively). Receiver operator curve analysis confirmed ILI had high predictive ability in both settings, improved by the inclusion of seasonality and influenza vaccination status (IISP: 0.61 vs 0.76, ORCHARDS: 0.68 vs 0.78). Conclusions: ILI performed well in both clinical and community contexts. Factors most highly associated with increased odds of RT-PCR(+) results were cough, fever, and ILI. Inclusion of seasonality and influenza vaccination status improved the predictive value of ILI in both datasets.

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在临床和学校社区环境中评估和比较 ILI 病例定义:ORCHARDS/IISP.
背景:流感样病症(ILI)通常用于临床和公共卫生环境中识别流感病例。疾病预防控制中心将流感样病症定义为发热、咳嗽或咽痛,且症状在 7 天内出现。目标:评估 ILI 标准在两种环境(临床和社区)中的表现,比较儿童流感的症状特征和实验室检测结果。研究设计与分析:对流感医疗监测(MAI)数据和社区研究数据进行回顾性分析。对数据集分别进行分析,以评估流感病例的预测因素。分析仅限于症状出现后 7 天内采集的标本。流感与每个分类变量之间的关系用混淆矩阵、灵敏度和特异性来描述。相关性采用卡方检验。以 RT-PCR 结果为结果的所有变量均采用未调整和调整的逻辑回归模型。环境或数据集:俄勒冈州呼吸道疾病导致的儿童缺勤研究(ORCHARDS)是一项呼吸道感染研究,研究地点位于俄勒冈州学区(威斯康星州戴恩县)。威斯康星州流感发病率监测项目 (IISP) 是一个 MAI 监测系统,在戴恩县的五个家庭医学诊所运行。研究人群:患有急性呼吸道感染的 4-18 岁儿童。干预/工具:由研究人员(ORCHARDS)或临床医生(IISP)采集口咽标本,在威斯康星州卫生实验室通过 RT-PCR 检测流感和多种呼吸道病毒。收集所有参与者的人口统计学和症状数据。结果测量:流感(+)PCR。结果:从 2010 年 7 月 9 日至 2020 年 12 月 3 日,IISP 和 ORCHARDS 分别收集了 1338 份和 2359 份符合纳入标准的标本。咳嗽、发热和 ILI 分类与流感显著相关(灵敏度分别≥92.8%、≥85.9% 和≥84.5%)。接收者运算曲线分析证实,ILI 在两种情况下都具有较高的预测能力,纳入季节性和流感疫苗接种情况后,预测能力有所提高(IISP:0.61 vs 0.76;ORCHARDS:0.68 vs 0.78)。结论ILI 在临床和社区环境中均表现良好。与 RT-PCR(+) 结果几率增加关系最大的因素是咳嗽、发烧和 ILI。纳入季节性因素和流感疫苗接种情况可提高两个数据集中 ILI 的预测价值。
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来源期刊
Annals of Family Medicine
Annals of Family Medicine 医学-医学:内科
CiteScore
3.70
自引率
4.50%
发文量
142
审稿时长
6-12 weeks
期刊介绍: The Annals of Family Medicine is a peer-reviewed research journal to meet the needs of scientists, practitioners, policymakers, and the patients and communities they serve.
期刊最新文献
Prehospital Clinical Decision-Making for Medication Administration for Behavioral Emergencies. Rapid Antigen Testing in School Health Offices for Surveillance of SARS-CoV-2 and Influenza A. Assessment and comparison of the ILI case definition in clinical and school-based community settings: ORCHARDS/IISP. Efficacy and Safety of BB-12 Supplemented Strawberry Yogurt For Healthy Children on Antibiotics (PLAY ON). Exploratory Pilot Studies to Demonstrate Mechanisms of Preventing Antibiotic-Associated Diarrhea and the Role for Probiotics.
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