Grant: Planning and Dissemination Grant - Institute Community Support

Influenza is a major public health concern, resulting in 180,000 emergency room visits and 12,200 hospitalizations per year in Canada. The use of diagnostic tests and proper interpretation of results is important to accurately identify patients with influenza. Timely and correct diagnosis reduces unnecessary antibiotic prescribing and increases prompt antiviral use to improve patient care and outcomes. Although lab-based tests are the gold standard for influenza diagnosis, there are inherent delays in result reporting. Rapid influenza diagnostic tests (RIDTs) are simple enough to use outside the lab and provide results in 10-30 minutes. First generation RIDTs have poor sensitivity (ability to detect true cases). Recently, two new classes of RIDTs, digital immunoassays (DIAs) and rapid nucleic acid amplification tests (NAATs), were commercialized. In 2017, we published a landmark systematic review demonstrating significantly higher sensitivities for DIAs (77-80%) and NAATs (92-95%) than for first-generation RIDTs (53-55%). However, the number of DIA and NAAT studies available at the time limited our ability to perform important subgroup analyses. New technologies have since been approved and 20 additional DIA/NAAT studies were published last year, highlighting that as technologies evolve, evidence emerges at a rapid pace. Thus, we propose to develop and pilot a website for a Living Systematic Review (LSR) with continual, active monitoring of the evidence to update our review as new data become available. An LSR is an efficient, cost-effective, and pragmatic solution to the challenge of rapid research output. LSRs capitalize on existing reviews to ensure their continued usefulness for end-users. This LSR will continuously integrate the latest RIDT evidence into actionable summaries on a website that we will develop. With our knowledge users, our work will inform national influenza clinical and laboratory practice guidelines and public health surveillance strategies.