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Review
. 2019 Aug 26;57(9):e00373-19.
doi: 10.1128/JCM.00373-19. Print 2019 Sep.

Cost-Effective Respiratory Virus Testing

Affiliations
Review

Cost-Effective Respiratory Virus Testing

B A Pinsky et al. J Clin Microbiol. .

Abstract

The timely and accurate diagnosis of respiratory virus infections has the potential to optimize downstream (posttesting) use of limited health care resources, including antibiotics, antivirals, ancillary testing, and inpatient and emergency department beds. Cost-effective algorithms for respiratory virus testing must take into consideration numerous factors, including which patients should be tested, what testing should be performed (for example, antigen testing versus reverse transcription-PCR testing or influenza A/B testing versus testing with a comprehensive respiratory virus panel), and the turnaround time necessary to achieve the desired posttesting outcomes. Despite the clinical impact of respiratory virus infections, the cost-effectiveness of respiratory virus testing is incompletely understood. In this article, we review the literature pertaining to the cost-effectiveness of respiratory virus testing in pediatric and adult patient populations, in emergency department, outpatient, and inpatient clinical settings. Furthermore, we consider the cost-effectiveness of a variety of testing methods, including rapid antigen tests, direct fluorescent antibody assays, and nucleic acid amplification tests.

Keywords: respiratory viruses.

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Figures

FIG 1
FIG 1
Respiratory virus testing algorithms. (A) All patients with ILI are tested using an influenza A/B test. (B) All patients with ILI are tested with a respiratory pathogen panel. (C) Patients with ILI are tested with an influenza A/B test and, if the results are negative, then reflex testing with a respiratory pathogen panel is performed. (D) Patients with ILI are tested with an influenza A/B test or a respiratory pathogen panel depending on underlying diseases and the severity of the presentation.

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