The authors were interested in the impact of point-of-care tests (POCTs) for influenza on patient outcomes. They performed a systematic review of influenza POCTs versus usual care in ambulatory care settings. 12,928 citations were screened and seven randomised studies (n = 4324) and six non-randomised studies (n = 4774) were identified and included. Most of the evidence came from paediatric emergency departments. The authors found that in randomised trials, POCTs had no effect on admissions (relative risk [RR] 0.93, 95%CI 0.61-1.42), returning for care (RR 1.00 95%CI 0.77-1.29) or antibiotic prescribing (RR 0.97, 95%CI 0.82-1.15). However, it did lead to an increase in the prescribing of antivirals (RR 2.65, 95%CI 1.95-3.60). Further testing was reduced for full blood counts (RR 0.80, 95%CI 0.69-0.92), blood cultures (RR 0.82, 95%CI 0.68-0.99) and chest radiography (RR 0.81, 95%CI 0.68-0.96), but not urinalysis (RR 0.91, 95%CI 0.78-1.07). The time spent by patients in the emergency department did not change. Also, in contrast, fewer non-randomised studies reported these outcomes, with some of the findings reversed or attenuated (fewer antibiotic prescriptions and less urinalysis in tested patients). Therefore point-of-care testing for influenza does influence prescribing and testing decisions, particularly for children in emergency departments.
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