The accuracy of Influenza A (H1N1) "swine flu" laboratory testing: A systematic review of diagnostic test accuracy.

Abstract

Review question/objective The aim of this systematic review is to comprehensively search the available literature and to synthesise the best available evidence to determine the diagnostic accuracy of currently available laboratory tests for swine flu (H1N1), using viral culture as a reference test. Inclusion Criteria Types of participants Studies will be considered for inclusion in the review if the participants are human patients exhibiting influenza-like symptoms who have been tested for swine flu (H1N1) using both a diagnostic and reference test. There will be no exclusion based on age, gender or co-morbidities, but subgroup analysis will be conducted if there is sufficient data and if appropriate. Phenomenon of interest The phenomenon of interest is the correct identification of H1N1 infection. This review will consider studies that compare the accuracy of laboratory tests aiming to diagnose swine flu (H1N1) in patients presenting with influenza-like symptoms, in comparison to viral culture. Outcome measures The accuracy of diagnostic tests will be determined by how well the test correctly gives positive results for patients with confirmed swine flu (H1N1) and negative results for patients without, as determined by viral culture. It is anticipated that data will be presented as raw test results or sensitivities and specificities of the test compared with viral culture will be presented. Other statistics to elaborate on diagnostic test accuracy may include likelihood ratios and/or predictive values.