Study Detail

FLU-CATs : Evaluation and refinement of pandemic influenza community assessment tools

Real time refinement and validation of criteria and tools used in primary care to aid hospital referral decisions for patients of all ages in the event of surge during an influenza pandemic.

Status: Open

Type: Observational

Funder: NIHR

Sponsor: University of Liverpool

CI: Prof Malcolm Semple

IRAS-Number: 30029

CPMS-ID: 12827

Approval Date: 20 March 2020

Description:

Design: A prospective analysis, linking criteria in a GP's assessment of patients presenting with influenza like illness, to immediate management decisions and patient outcomes. Objective: Assessment, refinement and validation of triage tools to guide GP referral of patients with influenza like illness during a pandemic in readiness for use should widespread illness exceed health care capacity (surge). Method: GPs participating in the Clinical Practice Research Datalink (CPRD) will record their assessment and management of patients with influenza like illness. We will explore linking CPRD to the HPA supra-regional microbiology network database to provide linked-anonymised results on microbiological investigations for respiratory pathogens. Analysis: Weekly cumulative analyses are planned using CPRD data. Three monthly analyses are planned using linked HES data as a gold standard. Univariate and multivariate analyses using unconditional logistic regression will be used to investigate the association between triage criteria threshold values and primary outcomes (hospital admission, and death) and secondary outcomes (length of stay and augmented levels of care (high dependency / intensive care)). The threshold values of triage criteria will be refined by comparing the receiver operator characteristics at various thresholds of abnormality (e.g. respiratory rate >30, >35, >40). The discriminatory value of existing and refined triage tools will be compared using logistic regression. Triage tools will be compared for their ability to predict outcomes using Area Under the Receiver Operating Characteristic Curve (AUROC) comparisons. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) will be calculated for triage tools using different score thresholds. Analysis will be reset between pandemic waves.

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