ArticleClinical transplantation2015
Poor positive predictive value of influenza-like illness criteria in adult transplant patients: a case for multiplex respiratory virus PCR testing.
Article in Clinical transplantation, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- Practical Guidance for Clinical Microbiology Laboratories: Viruses Causing Acute Respiratory Tract Infections.Clinical microbiology reviews · 2019Guideline
- Clinical Practice Guidelines by the Infectious Diseases Society of America: 2018 Update on Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management of Seasonal Influenzaa.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2019Article
- Post-transplant Viral Respiratory Infections in the Older Patient: Epidemiology, Diagnosis, and Management.Drugs & aging · 2017Review
- Retrospective analysis of clinical and virological parameters of influenza cases at four university hospitals in Germany, 2015.Infection · 2017Article
- Viral Pneumonia in Patients with Hematologic Malignancy or Hematopoietic Stem Cell Transplantation.Clinics in chest medicine · 2017Review
- Poor positive predictive value of influenza-like illness criteria in adult transplant patients: a case for multiplex respiratory virus PCR testing.Clinical transplantation · 2015Article
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRespiratory viral infections (RVIs) are a significant cause of morbidity and mortality among transplant patients. The CDC's influenza-like illness (ILI) criteria (fever ≥100°F with cough and/or sore throat) are a screening tool for influenza with unknown applicability to the transplant population.
methodsWe reviewed all respiratory virus PCR tests performed on adult patients with a history of solid organ (SOT) or stem cell transplantation (HSCT) during the 2012-2013 influenza season. The positive (PPV) and negative predictive values (NPV) of ILI criteria were calculated.
resultsOf 126 transplant patients (66 HSCT, 60 SOT), 54 (42.8%) tested positive for an RVI by PCR: 24 influenza and 30 non-influenza. Of 30 patients who met ILI criteria, 12 (40%) were positive for influenza. The PPV and NPV of ILI for influenza were 50% and 82.4%, respectively. Mortality was low (3.7%), but morbidity was high (14.8% required ICU stay) among transplant patients diagnosed with RVI.
conclusionsInfluenza and non-influenza RVIs are associated with significant morbidity among transplant patients. CDC ILI criteria correlate poorly with PCR-positive cases of influenza in transplant patients, but may be useful in excluding the diagnosis. Routine RVI PCR testing is recommended for better diagnosis and improved antiviral use in transplant patients with suspected RVI.
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