This foundation supported research project which examined the validity of antigen testing for respiratory syncytial virus (RSV) in the emergency department has finally published ahead of print in the emergency medicine journal (EMJ). EM J is the BMJ stable emergency medicine journal. The paper entitled “Is the interpretation of rapid antigen testing for respiratory syncytial virus as simple as positive or negative?”  was a prospective diagnostic study which included 607 infants and toddlers with bronchiolitis. The authors found perhaps unsurprisingly that the antigen test did not perform nearly as well has the manufacturers claim it did. They then took this step further and demonstrated how the relatively poor performance could be improved by interpreting it in the context of other children who present to the emergency department.

This is of course exactly what pediatric emergency physicians always done; if a resident tells us this patient is RSV positive in the middle of June our initial reaction is “Well maybe”.  This study demonstrates both why this is the case and also helps quantify that ‘maybe’ in an unusual graphical portrayal of the contextual logistic regression multivariate analysis.   

The link is here. Unfortunately there is a pay wall.  Foundation supporters can receive a free reprint directly from the the foundation.