Project Details

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You can view the full text from the H1N1 influenza and pandemic flu themed issue 1 publication details page on the HTA website

Emergency department assessment of patients with suspected swine flu needs to identify which patients have severe illness and need hospital admission. Several systems or scores have been recommended by various groups to assess severity of illness but none of them has actually been tested in patients with flu. It is likely that resources will be scarce during a pandemic and any system for allocating them will have to be fair and consistent.

We plan to use patient data from the early phases of a pandemic to test the various scores and to identify simple measurements (such as blood pressure, pulse rate or breathing rate) that could improve the ability of these scores to identify which patients are most likely to die or require life-saving treatment. The best scores can then be used in subsequent phases of a pandemic to make sure that people with the most severe illness are admitted to hospital.

The risks to patients involved in the study are very low. The project will not involve any change to the way patients are investigated or treated. Data collection has been designed to assist medical staff so that it does not interfere with patient care. Personal details will be removed from any data that leaves the hospital so that patients cannot be personally identified.

The project will be undertaken by experienced researchers in hospitals in Sheffield and Manchester. They include experts in emergency medicine, chest medicine, intensive care, public health and statistics. The Clinical Trials Unit in Sheffield is registered to provide research support and will be responsible for collecting and analysing the data.

1. To determine the discriminant value of currently available emergency department triage methods for predicting severe illness or death in patients presenting with suspected pandemic influenza

2. To determine the independent predictive value of presenting clinical characteristics and routine tests for severe illness or death in patients presenting with suspected pandemic influenza

3. To determine whether the discriminant value of emergency department triage can be improved by developing two new triage methods based upon (a) presenting clinical characteristics alone and (b) presenting clinical characteristics, electrocardiogram (ECG), chest X-ray and routine blood test results