Costo-efectividad en la detección de influenza H1N1: datos clínicos versus pruebas rápidas

objective: evaluate the performance of clinical data and the rapid influenza diagnostic test (ridt) in diagnosing influenza h1n1, and analyze the cost-benefit of using this diagnostic tool. methods: the ridt was used for patients who came to four hospitals in mexico city with an influenza-like illness (ili) in october and november 2009. the diagnostic performance of the ili clinical data and the ridt was compared to that of the real-time reverse transcription polymerase chain reaction (rrt-pcr) test. the rrt-pcr test was conducted in a reference laboratory and blinded to the results of the ridt. an economic evaluation also was conducted to estimate the budgetary impact of using the ridt. results: the study included 78 patients, 39 of whom tested positive for influenza h1n1 and 6 tested positive for seasonal influenza a, according to the results of the rrt-pcr. the ili clinical data yielded a sensitivity of 96% and specificity of 21%; the ridt yielded a sensitivity of 76% and specificity of 82%; and the ili clinical data and ridt together yielded a sensitivity of 96% and specificity of 100%. the positive likelihood quotient for ili-headaches was 31.5 and that of ili-odynophagia, 330. the use of ridt yielded savings of us$12.6 per each suspected case. conclusions: use of the ridt to aid in the diagnosis of influenza h1n1 increases certainty and lowers the average cost per suspected and infected patient.