Is it the flu, or just a cold?

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.

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