Rhiza Labs FluTracker Forum

Mkey
this is what Capeman just said

"True but then if you actually have H1N1 and get tested there is still a 1 in 3 chance the test will say you don't have it. It's clinically irrelevant in a deadly pandemic."

"My question: If, as Kathleen Sibelius states, doctors should just treat symptoms and not test, WHY are doctors still using the rapid tests, falsely assuring families that their child does NOT have the swine flu? I've had several students say that they've had the fast test, it was negative, and they're back with their sniffles, sore throats, etc."


WE have seen that too, I have a feeling it has more to do with this
http://www.google.com/finance?client=ob&q=NASDAQ:QDEL

MKEY
Dr. Niman asked me to look at your posts for secondary infections,
I cant find it can you send it to me? He said you were very knowledgeable in this.

I have only reviewed the MMWR's
Or PM me?

Kind Regards
April

Happy wrote:

I don't think the test is entirely worthless or shouldn't ever be used. A positive test is a very good confirmation of influenza being present and rules in the diagnosis when a doctor is questioning whether flu-like symptoms represent the flu or something else. It is an excellent basis upon which to make a treatment decision to start antiviral medication and/or prescribe bed rest, fluids, and staying home from work/school. One can be pretty darn confident that a positive test on an RIDT means the person really does have the flu. The problem comes in when people overestimate what a negative test result can tell them. Essentially, a negative test doesn't really tell you much at all. It doesn't tell you whether the person does or doesn't have the flu and shouldn't be treated as if it does. Decisions not to start antiviral or to allow a child to attend school, etc. should NOT be made based on a negative test result. I'd agree that if the negative rapid test results are being misused this way, it isn't helpful.

I may have misread or misinterpreted what you said earlier. It appeared to me you were alleging that the CDC wanted schools to be left open in a deliberate play to have the kids get sick and be dealt with now before the the real pandemic wave hit later, thinking perhaps that such a move would mitigate or ease the later wave, when you said, "But do not be fooled, the CDC knows EXACTLY what they are doing. IT appears to me, they want as many areas sick as possible BEFORE the real wave (hence the returning children to school after 24 hours)." Such a move by the CDC, if this were in fact their rationale, would not be based on what the WHO recommends or on sound science.

Yes we had a communication break down.
Someone implied (or it is how I read it) that they are unaware of what is going on so they are making bad decisions.

I said they know exactly what is going on, and they are making decisions based on models and projections. I did not say those were correct, in fact like you I think things could have been done far better.

But they DO know exactly what is going on, they are just not doing what they probably should be doing to deal with it.

See you said this:
"Essentially, a negative test doesn't really tell you much at all. It doesn't tell you whether the person does or doesn't have the flu and shouldn't be treated as if it does. Decisions not to start antiviral or to allow a child to attend school, etc. should NOT be made based on a negative test result."

And that is EXACTLY how I feel about it. IF you are knowledgeable in its lack of selectivity then information could be used.

However, Capeman believes most doctors will not be bright enough to understand that in general and many people that should be treated, will not be. He is saying 1 in 3 people that should be treated will not be treated because of that test.
And the truth of the matter is that many MD's we speak to have no idea lack of selectivity.
And there is the problem so I can see his point too.
It seems though that many doctors are relying on the test instead of the accepting classic symptoms of flu for diagnosis. And I think you may be making an assumption that they are all as bright as you, and that may not be the case


Do you have the secondary infection posts?
Ill be offline a bit but I am very interested in the posts Dr. Niman was talking about.

I fear Capeman is correct on this score. Sensitivity and specificity, along with positive and negative predictive value for tests is taught in medical school, but such knowledge doesn't always get appropriately applied in a clinical setting.

Sometimes having diagnostic tests available makes people overly reliant on them and forgetful of their limitations. Clinical diagnosis sometimes seems (at least to this old fart) to be a dying art.

Just saw your request for posts on secondary infections. I'm not sure which one Dr. Niman means, but I'll find it/them and PM you.

Having seen many, many docs, I would have to concur the Mkey is among the brightest.

Aging has to have some perks, right?

This is so sad, this is one of the mortalities in which it was reported they went to the hospital more than once.
I cant remember how many there have been.

It appears this child was not given an antiviral because she tested negative on the Quidel kit and was sent home?

http://www.todaysthv.com/news/news.aspx?storyid=90746

I would say ALL NEGATIVES need a follow up method.