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Should clinical case definitions of influenza in hospitalized older adults include fever?

Falsey AR, Baran A, Walsh EE - Influenza Other Respir Viruses (2015)

Bottom Line: The highest temperature reported prior to admission or measured during the first 24 h after admission was recorded.The commonly used definition of ILI (fever ≥ 37·8°C and cough) resulted in 57% sensitivity and 71% specificity in older adults.Receiver operating characteristic curves examining the various temperature thresholds combined with cough and/or sore throat showed the optimal balance between sensitivity and specificity to be 37·9°C (AUC 0·71) and 37·3°C (AUC 0·66), in younger and older persons, respectively.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, University of Rochester, Rochester, NY, USA.

No MeSH data available.


Related in: MedlinePlus

Receiver operating characteristic curves of classification of influenza using temperature in subjects <65 years of age (N = 660) and ≥65 years of age (N = 1456). AUC, area under the curve.
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fig03: Receiver operating characteristic curves of classification of influenza using temperature in subjects <65 years of age (N = 660) and ≥65 years of age (N = 1456). AUC, area under the curve.

Mentions: Because the use of fever for the influenza case definition remains a specific concern in older adults, we constructed an ROC curve examining the diagnostic accuracy of temperature for influenza in individuals younger and older than 65 years of age with the presence of cough and/or sore throat (Figure3). This analysis shows that an optimal prediction threshold for persons aged 65 years and over is when fever is defined at a temperature ≥37·3°C. At this threshold, the sensitivity is 77% and the specificity is 49%. In this population, the ROC curve had an area under the curve (AUC) of 0·66. This is in contrast to the ROC curve for adults under 65 years of age, in which an optimal temperature threshold of ≥37·9°C is defined, resulting in a sensitivity of 57% and a specificity of 76%. The area under the ROC curve is modestly improved to 0·71 in this population.


Should clinical case definitions of influenza in hospitalized older adults include fever?

Falsey AR, Baran A, Walsh EE - Influenza Other Respir Viruses (2015)

Receiver operating characteristic curves of classification of influenza using temperature in subjects <65 years of age (N = 660) and ≥65 years of age (N = 1456). AUC, area under the curve.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4549099&req=5

fig03: Receiver operating characteristic curves of classification of influenza using temperature in subjects <65 years of age (N = 660) and ≥65 years of age (N = 1456). AUC, area under the curve.
Mentions: Because the use of fever for the influenza case definition remains a specific concern in older adults, we constructed an ROC curve examining the diagnostic accuracy of temperature for influenza in individuals younger and older than 65 years of age with the presence of cough and/or sore throat (Figure3). This analysis shows that an optimal prediction threshold for persons aged 65 years and over is when fever is defined at a temperature ≥37·3°C. At this threshold, the sensitivity is 77% and the specificity is 49%. In this population, the ROC curve had an area under the curve (AUC) of 0·66. This is in contrast to the ROC curve for adults under 65 years of age, in which an optimal temperature threshold of ≥37·9°C is defined, resulting in a sensitivity of 57% and a specificity of 76%. The area under the ROC curve is modestly improved to 0·71 in this population.

Bottom Line: The highest temperature reported prior to admission or measured during the first 24 h after admission was recorded.The commonly used definition of ILI (fever ≥ 37·8°C and cough) resulted in 57% sensitivity and 71% specificity in older adults.Receiver operating characteristic curves examining the various temperature thresholds combined with cough and/or sore throat showed the optimal balance between sensitivity and specificity to be 37·9°C (AUC 0·71) and 37·3°C (AUC 0·66), in younger and older persons, respectively.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, University of Rochester, Rochester, NY, USA.

No MeSH data available.


Related in: MedlinePlus