Predicting Streptococcal Pharyngitis in Adults
Author Information
Author(s): Aalbers Jolien, O'Brien Kirsty K, Chan Wai-Sun, Falk Gavin A, Teljeur Conor, Dimitrov Borislav D, Fahey Tom
Primary Institution: HRB Centre for Primary Care Research, Department of General Practice, RCSI Medical School, Dublin, Republic of Ireland
Hypothesis
Can the Centor score accurately predict group A β-haemolytic streptococcal pharyngitis in adults with sore throat symptoms?
Conclusion
The Centor score is a well-calibrated clinical prediction rule for estimating the probability of GABHS pharyngitis, but should be used cautiously in low prevalence settings.
Supporting Evidence
- Individual signs and symptoms generate only small shifts in post-test probability.
- The Centor score has reasonable specificity and can enhance appropriate prescribing of antibiotics.
- Calibration shows no significant difference between predicted and observed cases of GABHS pharyngitis.
Takeaway
Doctors can use a score based on symptoms to help decide if a sore throat is caused by a specific bacteria, but it's not always perfect.
Methodology
A systematic literature search was performed, and studies assessing the diagnostic accuracy of signs and symptoms and/or validating the Centor score were included in a meta-analysis.
Potential Biases
Observer variation in assessing signs and symptoms was poorly reported.
Limitations
There is moderate heterogeneity in the Centor score calibration analysis, and the throat culture as a reference standard may not distinguish between active infection and carriage.
Participant Demographics
The study focused on adults aged 15 years and older presenting with sore throat symptoms.
Statistical Information
P-Value
0.09
Confidence Interval
95% CI 0.72 to 0.88
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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