Jm-jabf210177 1123..1140

deemed potentially of interest by any reviewer, the full article was obtained and reviewed by the corresponding author and 1 other reviewer. Studies meeting inclusion and exclusion criteria were reviewed in parallel by 2 authors who each abstracted study characteristics including the type of validation (if any), study quality, and test accuracy data (true positive, false positive, false negative, and true positive in comparison with a valid reference standard). Discrepancies were resolved through consensus discussion. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool was adapted for our study and definitions for low, unclear and high risk of bias prespecified for each domain as shown in Appendix 3. Data Synthesis and Analysis For published CPRs, the probability of influenza in each risk group, likelihood ratios, and the proportion of patients in that risk group are reported. If a CPR reported more than 2 risk groups, the likelihood ratio was calculated for each risk group (“stratum specific likelihood ratios”). If a point score was proposed without identification of low, moderate and high-risk groups, we used clinical judgment to propose such groups post hoc based on test and treatment thresholds from a previous study and reported those findings separately from the original study findings. For published studies of a point score but reporting the area under the receiver operating characteristic curve (AUROCC), AUROCC was calculated using the pROC package in R.