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Improved Influenza Diagnostics through Thermal Contrast Amplification

Influenza poses a serious health threat and creates an economic burden for people around the world. The accurate diagnosis of influenza is critical to the timely clinical treatment of patients and the control of outbreaks to protect public health. Commercially available rapid influenza diagnostic te...

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Autores principales: Liu, Yilin, Zhan, Li, Wang, Yiru, Kangas, Joseph, Larkin, Daniel, Boulware, David R., Bischof, John C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7999055/
https://www.ncbi.nlm.nih.gov/pubmed/33800088
http://dx.doi.org/10.3390/diagnostics11030462
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author Liu, Yilin
Zhan, Li
Wang, Yiru
Kangas, Joseph
Larkin, Daniel
Boulware, David R.
Bischof, John C.
author_facet Liu, Yilin
Zhan, Li
Wang, Yiru
Kangas, Joseph
Larkin, Daniel
Boulware, David R.
Bischof, John C.
author_sort Liu, Yilin
collection PubMed
description Influenza poses a serious health threat and creates an economic burden for people around the world. The accurate diagnosis of influenza is critical to the timely clinical treatment of patients and the control of outbreaks to protect public health. Commercially available rapid influenza diagnostic tests (RIDTs) that are operated by visual readout are widely used in clinics to screen influenza infections, but RIDTs suffer from imperfect analytical sensitivity, especially when the virus concentration in the sample is low. Fortunately, the sensitivity can be simply improved through an add-on signal amplification step, i.e., thermal contrast amplification (TCA). To demonstrate the advantage of TCA for influenza diagnosis, we conducted a prospective cohort study on 345 clinical specimens collected for influenza A and B testing during the 2017–2018 influenza season. All samples were tested using the Quidel QuickVue Influenza A + B test, followed by a TCA readout, and then confirmatory polymerase chain reaction testing. Through the TCA detecting sub-visual weak positives, TCA reading improved the overall influenza sensitivity by 53% for influenza A and 33% for influenza B over the visual RIDTs readings. Even though the specificity was compromised slightly by the TCA protocol (relative decrease of 0.09% for influenza A and 0.01% for influenza B), the overall performance was still better than that achieved by visual readout based on comparison of their plots in receiver operating characteristic space and F1 scores (relative increase of 14.5% for influenza A and 12.5% for influenza B). Performing a TCA readout on wet RIDTs also improved the overall TCA performance (relative increase in F1 score of 48%). Overall, the TCA method is a simple and promising way to improve the diagnostic performance of commercial RIDTs for infectious diseases, especially in the case of specimens with low target analytes.
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spelling pubmed-79990552021-03-28 Improved Influenza Diagnostics through Thermal Contrast Amplification Liu, Yilin Zhan, Li Wang, Yiru Kangas, Joseph Larkin, Daniel Boulware, David R. Bischof, John C. Diagnostics (Basel) Article Influenza poses a serious health threat and creates an economic burden for people around the world. The accurate diagnosis of influenza is critical to the timely clinical treatment of patients and the control of outbreaks to protect public health. Commercially available rapid influenza diagnostic tests (RIDTs) that are operated by visual readout are widely used in clinics to screen influenza infections, but RIDTs suffer from imperfect analytical sensitivity, especially when the virus concentration in the sample is low. Fortunately, the sensitivity can be simply improved through an add-on signal amplification step, i.e., thermal contrast amplification (TCA). To demonstrate the advantage of TCA for influenza diagnosis, we conducted a prospective cohort study on 345 clinical specimens collected for influenza A and B testing during the 2017–2018 influenza season. All samples were tested using the Quidel QuickVue Influenza A + B test, followed by a TCA readout, and then confirmatory polymerase chain reaction testing. Through the TCA detecting sub-visual weak positives, TCA reading improved the overall influenza sensitivity by 53% for influenza A and 33% for influenza B over the visual RIDTs readings. Even though the specificity was compromised slightly by the TCA protocol (relative decrease of 0.09% for influenza A and 0.01% for influenza B), the overall performance was still better than that achieved by visual readout based on comparison of their plots in receiver operating characteristic space and F1 scores (relative increase of 14.5% for influenza A and 12.5% for influenza B). Performing a TCA readout on wet RIDTs also improved the overall TCA performance (relative increase in F1 score of 48%). Overall, the TCA method is a simple and promising way to improve the diagnostic performance of commercial RIDTs for infectious diseases, especially in the case of specimens with low target analytes. MDPI 2021-03-07 /pmc/articles/PMC7999055/ /pubmed/33800088 http://dx.doi.org/10.3390/diagnostics11030462 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ).
spellingShingle Article
Liu, Yilin
Zhan, Li
Wang, Yiru
Kangas, Joseph
Larkin, Daniel
Boulware, David R.
Bischof, John C.
Improved Influenza Diagnostics through Thermal Contrast Amplification
title Improved Influenza Diagnostics through Thermal Contrast Amplification
title_full Improved Influenza Diagnostics through Thermal Contrast Amplification
title_fullStr Improved Influenza Diagnostics through Thermal Contrast Amplification
title_full_unstemmed Improved Influenza Diagnostics through Thermal Contrast Amplification
title_short Improved Influenza Diagnostics through Thermal Contrast Amplification
title_sort improved influenza diagnostics through thermal contrast amplification
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7999055/
https://www.ncbi.nlm.nih.gov/pubmed/33800088
http://dx.doi.org/10.3390/diagnostics11030462
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