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Med."],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>This prospective observational study, conducted at a community clinic in Japan during the influenza season, from December 2017 to April 2018 aimed to investigate the accuracy of factors used for influenza self-diagnosis. Data were collected from pre-examination checklists issued to patients with suspected influenza and electronic medical records. Receiver operating characteristic (ROC) curve analysis was performed using a rapid influenza diagnostic test as the reference standard, and 2\u2009\u00d7\u20092 contingency tables were analysed at each cut-off point. We analysed data from 290 patients (72.8% males, median age: 38 years, interquartile range: 26\u201350 years). The area under the ROC curve (AUC) for patients who were aware of other patients presumed to have influenza within close proximity was 0.74 (95% confidence interval (CI): 0.66\u20130.82). The AUCs for patients with a history of influenza, unvaccinated status, cough, or nasal discharge were 0.68 (95% CI: 0.60\u20130.75), 0.66 (95% CI: 0.59\u20130.73), 0.67 (95% CI: 0.59\u20130.75), and 0.70 (95% CI: 0.62\u20130.78), respectively. The sensitivity, specificity and positive likelihood ratio at a 90% cut-off point was 19.5% (95% CI: 13.5\u201326.6%), 94.1% (95% CI: 88.7\u201397.4%) and 3.31 (95% CI: 1.57\u20136.98). The sensitivity, specificity and negative likelihood ratio at a 10% cut-off point was 95.5% (95% CI: 90.9\u201398.2%), 9.6% (95% CI: 5.2\u201315.8%) and 0.48 (95% CI: 0.20\u20131.16). After multivariate logistic regression analysis, the AUC increased significantly from 0.77 (95% CI: 0.70\u20130.83) to 0.81 (95% CI: 0.76\u20130.86) when self-diagnosis-related information was added to basic clinical information. We identified factors that improve the accuracy and validity of influenza self-diagnosis. Appropriate self-diagnosis could contribute to the containment efforts during influenza epidemics and reduce its social and economic burden.<\/jats:p>","DOI":"10.1038\/s41533-020-0165-3","type":"journal-article","created":{"date-parts":[[2020,3,23]],"date-time":"2020-03-23T11:03:40Z","timestamp":1584961420000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Factors associated with seasonal influenza self-diagnosis: a prospective observational study in Japan"],"prefix":"10.1038","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9642-9116","authenticated-orcid":false,"given":"Hiroki","family":"Maita","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2001-4464","authenticated-orcid":false,"given":"Tadashi","family":"Kobayashi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Akimoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fumihiko","family":"Matsuoka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Osawa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroyuki","family":"Kato","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,3,23]]},"reference":[{"key":"165_CR1","unstructured":"National Institute of Infectious Diseases. 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