FluScoreVax Incorporates Vaccination History to Accurately Predict Influenza Risk

Is the FluScoreVax risk scoring tool accurate for assessing the risk of influenza in adult outpatients with a chief symptom of acute cough?

The updated FluScoreVax risk score has incorporated vaccination status and accurately identifies adults presenting with acute cough during flu season at low risk of influenza. These patients are unlikely to benefit from point-of-care influenza testing or treatment. (Level of Evidence = 1b)

The original FluScore risk tool for predicting influenza was developed without access to vaccination data. The investigators used data that was obtained from 12 European countries during flu season to derive and internally validate the updated FluScoreVax, which incorporates vaccine status, in 1,526 adults who presented to outpatient clinics with acute cough or suspected lower respiratory tract infection. Patient-reported symptoms were recorded, with polymerase chain reaction testing serving as the reference standard for diagnosing influenza. The final risk score included subjective fever, interference with usual activity, headache, wheeze, phlegm, and influenza vaccine status (range: −5 to 6 points) and was externally validated in a contemporary US population dataset.

The overall prevalence of influenza in both studies was approximately 15%. The FluScoreVax classified 61% of patients in the external validation cohort as low risk (−5 to 0 points) with only 7% testing positive for influenza.

Study design: Decision rule (validation)

Funding source: Government

Setting: Outpatient (primary care)

Author disclosure: No relevant financial relationships.