Millman Alexander J, Reed Carrie, Kirley Pam Daily, Aragon Deborah, Meek James, Farley Monica M, Ryan Patricia, Collins Jim, Lynfield Ruth, Baumbach Joan, Zansky Shelley, Bennett Nancy M, Fowler Brian, Thomas Ann, Lindegren Mary L, Atkinson Annette, Finelli Lyn, Chaves Sandra S
Emerg Infect Dis. 2015 Sep;21(9):1595-601. doi: 10.3201/eid2109.141665.
Diagnostic test sensitivity affects rate estimates for laboratory-confirmed influenza-associated hospitalizations. We used data from FluSurv-NET, a national population-based surveillance system for laboratory-confirmed influenza hospitalizations, to capture diagnostic test type by patient age and influenza season. We calculated observed rates by age group and adjusted rates by test sensitivity. Test sensitivity was lowest in adults >65 years of age. For all ages, reverse transcription PCR was the most sensitive test, and use increased from <10% during 2003-2008 to ≈70% during 2009-2013. Observed hospitalization rates per 100,000 persons varied by season: 7.3-50.5 for children <18 years of age, 3.0-30.3 for adults 18-64 years, and 13.6-181.8 for adults >65 years. After 2009, hospitalization rates adjusted by test sensitivity were ≈15% higher for children <18 years, ≈20% higher for adults 18-64 years, and ≈55% for adults >65 years of age. Test sensitivity adjustments improve the accuracy of hospitalization rate estimates.
诊断测试的敏感性会影响实验室确诊的流感相关住院率的估计。我们使用了FluSurv-NET的数据，这是一个基于全国人口的实验室确诊流感住院监测系统，以按患者年龄和流感季节获取诊断测试类型。我们按年龄组计算了观察到的发病率，并按测试敏感性调整了发病率。测试敏感性在65岁以上的成年人中最低。对于所有年龄段，逆转录聚合酶链反应（RT-PCR）是最敏感的测试，其使用比例从2003 - 2008年期间的不到10%增加到2009 - 2013年期间的约70%。每10万人中观察到的住院率因季节而异：18岁以下儿童为7.3 - 50.5，18 - 64岁成年人为3.0 - 30.3，65岁以上成年人为13.6 - 181.8。2009年之后，经测试敏感性调整后的住院率，18岁以下儿童约高15%，18 - 64岁成年人约高20%，65岁以上成年人约高55%。测试敏感性调整提高了住院率估计的准确性。
