An important question for doctors and patients during flu season is this: Is there an accurate clinical decision rule for guiding point-of-care testing and empiric therapy for adults with suspected influenza? It turns out there may be.
A recent study [PubMed® abstract | Free full-text JABFM article PDF] showed that a clinical decision rule can be used to guide point-of-care management of adults with suspected influenza. The rule is based upon the following:
- 2 points for fever plus cough,
- 2 points for myalgia (achy muscles),
- 1 point for symptom duration of less than 48 hours, and
- 1 point for chills or sweats.
The risk for influenza using this rule was
- 8% for 0 to 2 points,
- 30% for 3 points, and
- 59% for 4 to 6 points.
The authors state that during influenza season clinicians should consider empiric therapy for patients at high risk (4-6 points); point-of-care rapid testing for those at moderate risk (3 points); and observation only for those at low risk (0-2 points).
You may want to file this away for the next flu season. I know I will.