To the Editor: Uncontrolled before‐and‐after studies are highly prone to bias. Wabe and colleagues report on the impact of rapid influenza testing on outcomes for emergency department (ED) patients.1 They compared outcomes across four hospitals between the 2016 influenza season, when standard testing was used, and 2017, when rapid testing was used. Rapid testing was associated with shorter test turnaround times, more patients receiving results, and lower admission rates.
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- 1. Wabe N, Li L, Lindeman R, et al. The impact of rapid molecular diagnostic testing for respiratory viruses on outcomes for emergency department patients. Med J Aust 2019; 210: 316–320. https://www.mja.com.au/journal/2019/210/7/impact-rapid-molecular-diagnostic-testing-respiratory-viruses-outcomes-emergency
- 2. Goodacre S. Uncontrolled before‐after studies: discouraged by Cochrane and the EMJ. Emerg Med J 2015; 32: 507–508.
- 3. NSW Health. Influenza monthly epidemiology report, NSW, December 2017 (including a summary for the year 2017). Sydney: NSW Government, 2018. https://www.health.nsw.gov.au/Infectious/Influenza/Publications/2017/december-flu-report.pdf (viewed Nov 2019).
- 4. Bernal JL, Cummins S, Gasparrini A. Interrupted time series regression for the evaluation of public health interventions: a tutorial. Int J Epidemiol. 2017; 46: 348–355.
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