- In 2017, influenza in Australia caused 1,255 deaths, and this year has started with a bang: 20,000 case of flu have already been reported in 2019, with experts predicting record flu numbers.
- The conventional flu test can take up to 26 hours to deliver results: The new rapid flu test has been shown to deliver results in just over two hours, potentially resulting in less hospital admissions and fewer hospital resources implicated.
- Improving the timeliness of diagnosis: When the rapid flu test is used, 70% of patients can be accurately diagnosed while in the emergency department, compared to less than 2% using the conventional test.
- Delays in influenza testing may lead to misdiagnosis and greater hospital admissions: Macquarie University researchers have provided evidence to support the rapid flu test being implemented into emergency departments nationally.
As Australia grapples with a particularly severe start to the new flu season, new research published today in the prestigious Medical Journal of Australia could change the way Australians are diagnosed and treated for the condition. The new Macquarie University research has proven, for the first time, the marked difference on patient outcomes and hospital resources when a new, rapid flu test, is made available in emergency departments to diagnose and assess patients presenting with suspected influenza.
The Australian Institute of Health Innovation at Macquarie University, in partnership with NSW Health Pathology and Prince of Wales Hospital found that 67% of patients received their results from their rapid flu test before leaving the emergency department compared to the 1.3% who receive their results before leaving, using the conventional test.
1,491 patients were tested using a conventional test during July – December 2016, while 2,250 were tested using the rapid PCR between July – December 2017. The results demonstrated substantial differences in a number of areas including: i) a reduction in hospital admissions; ii) faster test turnaround times; iii) more patients receiving results while in the emergency department before either going home or admitted into hospital. This timely receipt of results led to the avoidance of additional laboratory testing.
Lead author Dr Nasir Wabe from the Australian Institute of Health Innovation at Macquarie University says the findings are important considering the significant consequences associated with flu each year.
“Our research shows that if patients can be assessed quicker, we can prevent hospital admissions, alleviating pressure on already busy hospitals, as well as limit the spread of influenza further.
“From prior research, we know that where hospitals use the conventional test, waiting up to 26 hours for results, patients can be admitted to hospital and even prescribed treatment before results are determined. This leads to hospital resources being used in ways that may not be necessary or most useful,” says Dr Wabe.
“Our research importantly points to financial savings. If patients are able to receive their results quicker, fewer additional tests, such as blood cultures, need to be ordered to diagnose a patient, thereby saving the health system money.”
Influenza significantly costs the Australian economy in lost productivity and absenteeism as well as costs to the health system. While Dr Wabe recommends a formal cost-benefit analysis of the rapid PCR, the research has found there are clear benefits and cost savings to be found.
NSW Health Pathology Executive Director of Clinical Operations, Associate Professor Rob Lindeman says: “By using rapid flu testing at our hospital-based pathology labs, we are able to provide a diagnosis within one to four hours. Prior to the introduction of this technology, testing was only able to be performed in batches at larger sites, so that results were commonly not available on the day of testing. The rapid flu testing program supports immediate decision-making and bed management and has been extremely well received by clinicians and health services.”
Associate Professor Jeffrey Post, Senior Staff Specialist in Infectious Diseases at The Prince of Wales Hospital which was one of the sites where the study was undertaken says: “This study demonstrates that by rapidly providing a diagnosis through rapid testing, unnecessary investigations and potentially unnecessary hospital admissions can be avoided. In influenza seasons with large numbers of cases this could provide benefits to the health care system as a whole”.
Acknowledgement: This project was part of a partnership funded by the National Health and Medical Research Council of Australia Partnership Project Grant in partnership with NSW Health Pathology and the Australian Commission on Safety and Quality in Health Care.
Wabe N, Li L, Lindeman R, Yimsung R, Dahm M, Clezy K, McLennan S, Westbrook J, Georgiou A. The impact of rapid molecular diagnostic testing for respiratory viruses on outcomes for emergency department patients. Medical Journal of Australia. April 2019.
