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14th, March
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Doctor Hui-Xian Pan, Pediatrician
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We found the importance of developing a rapid influenza diagnostic test with higher sensitivity and accuracy to help doctors make the best diagnosis and help the government for the statistics of epidemiology.
Doctor Hui-Xian Pan
Chung Shan Medical University Hospital
![](https://static.igem.org/mediawiki/2019/a/a6/T--CSMU_Taiwan--ihp1.png)
Form
We had an interview with Doctor Hui-Xian Pan(潘蕙嫻) on 14th, March at Chung-Shan Medical University Hospital. Dr. Pan is a pediatrician at Chung-Shan Medical University Hospital and also the clinical lecturer of the department of medicine. Her specialty is of pediatric infection, such as unknown fever, pneumonia, otitis media, skin infection and etc. Vaccine, rapid diagnostic test, prevention and treatment of pediatric infection are also her specialties.
purpose
Through the interview, we would like to know more about how clinical doctors deal with influenza and what they think of rapid diagnostic tests. Moreover, since doctors are at the front line facing patients, we can also find out what patients and their families think of the issue through interviewing doctors. Doctors are the middlemen between patients and hospitals and even the government, we want to know doctors' standpoint, what they think of hospitals and the government, and what role they act. We drafted the questions below:
- When do doctors use rapid influenza diagnostic tests?
- If patients have the symptom of influenza, will doctors use rapid influenza diagnostic tests? Or do doctors simply prescribe Tamiflu?
- Do rapid influenza diagnostic tests cause any inconvenience on diagnosis and treatment because of its inaccuracy or other factors?
- Is Tamiflu included in National Health Insurance? And is there any limitation for prescribing Tamiflu?
- If there is a product that can confirm influenza more accurately and more conveniently, what advantages it may bring to patients and doctors? If this product is cheaper than the existing one, what advantage will it bring to you?
- If there is a product that can differentiate typed A and type B, or even the subtype of type A, will it help doctors make diagnoses or treatments? Will it help the government conduct epidemiological statistics?
- Is it possible for patients to use rapid influenza diagnostic tests by themselves? And is it possible for patients to purchase rapid influenza diagnostic tests in pharmacies by themselves?
process
- Doctors will use rapid influenza diagnostic tests when they find patients having symptoms of influenza, such as cough, sneezing, nasal congestion, runny nose, heat, fever, and muscle pain. Then they make a confirmation with the results. Doctors usually make the diagnosis as an influenza infection when patients showing typical symptoms, such as fever for one to three weeks and muscle pain.
- Sometimes doctors simply prescribe Tamiflu for patients when patients’ symptoms are very typical. If doctors suspect other possibilities, they prescribe rapid tests for confirmation. Some parents persist in getting a definite diagnosis of their children. Then, doctors will prescribe rapid tests.
- The accuracy of rapid influenza diagnostic tests is not very high. In fact, doctors usually make diagnose with a patient’s clinical symptoms. If the symptoms are typical, doctors still prescribe Tamiflu even when the results of rapid tests are negative. Even doctors aren’t a hundred percent confident if the way of diagnosis the best treatment for patients.
- Tamiflu is covered by National Health Insurance, and the limitation for prescribing this medicine will be lowered during the influenza epidemic period. Doctors are able to prescribe Tamiflu even the result of the rapid influenza diagnostic test is negative. Moreover, doctors can prescribe Tamiflu when a patient’s second-degree relatives are infected by influenza but patients being healthy.
- For the question that if there is a product that can confirm influenza more accurately and more conveniently, Dr. Pan gave us some ideas. First, for patient’s parents or for patients, they can know what exactly their diseases are. Second, doctors can make confirmation if patients get influenza and would not prescribe the wrong medicine. Third, out of the flu season, doctors can only prescribe Tamiflu if the result of rapid tests are positive. If we can elevate the accuracy of the rapid test, we help doctors solve the problems that not allowed to prescribe Tamiflu while they are confident with their diagnosis, but rapid test showing negative results.
- The cheaper cost of rapid test kits does not have an impact on doctors, because it is hospitals that purchase medical supplies. The price factor is more related to hospitals. For patients, because of the National Health Insurance, the test fee is covered thus patients have no idea about the price. The price factor would only affect the government and hospitals.
- In a general situation, a product that can differentiate type A and B or even the subtype does not have an impact on doctors’ diagnoses. However, for patients with immunodeficiency, the medication would be different. Some patients with immunodeficiency are rejected by some medications. The treatments for specific subtypes must be developed.
- For the government, they often cooperate with laboratories. Laboratories help collect data from several hospitals or clinics and give the results to the government for statistics of epidemiology.
- It is impossible for patients to use the rapid influenza diagnostic test by themselves or buy a rapid influenza diagnostic test kit in pharmacies. Doctors insert a long cotton swab into patients' deep throats for collecting the sample of epithelial cells. This procedure must be taken by a professional and well-trained doctor, so general patients are not allowed to do it at home.
- The amount of influenza virus in patients' saliva is very small, so it is hard to detect just through the patients' salvia. If there is a product with higher sensitivity and accuracy, it may be possible conducting rapid influenza diagnostic tests with patients' saliva.
- Sometimes doctors of other sub-specialists may not be familiar with the symptoms of influenza. If there is a rapid influenza diagnostic test that is more accurate and more convenient, it may help them make diagnoses and give appropriate treatment to patients ASAP.
Feeback
After the interview, we found out that doctors often diagnose patients as flu through their symptoms and confirm by rapid influenza diagnostic tests. However, as the raising of patients' self-consciousness, patients would like to know what disease they exactly have. Therefore, it is important to have a more accurate and faster way to detect influenza to help doctors make the best diagnosis. Moreover, we found that to distinguish the subtype of influenza would help the government for the statistics of epidemiology. Through this interview, we found the importance of developing a rapid influenza diagnostic test with higher sensitivity and accuracy.