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Participatory Medicine: A Home Score for Streptococcal Pharyngitis Enabled by Real-Time Biosurveillance
Filetype[PDF - 421.08 KB]


Details:
  • Pubmed ID:
    24189592
  • Pubmed Central ID:
    PMC3953456
  • Description:
    Background

    Consensus guidelines recommend that adults at low risk for group A streptococcal (GAS) pharyngitis be neither tested nor treated

    Objective

    To help patients decide when to visit a clinician for the evaluation of sore throat.

    Design

    Retrospective cohort study.

    Setting

    A national chain of retail health clinics.

    Patients

    71 776 patients aged 15 years or older with pharyngitis who visited a clinic from September 2006 to December 2008.

    Measurements

    The authors created a score using information from patient-reported clinical variables plus the incidence of local disease and compared it with the Centor score and other traditional scores that require clinician-elicited signs.

    Results

    If patients aged 15 years or older with sore throat did not visit a clinician when the new score estimated the likelihood of GAS pharyngitis to be less than 10% instead of having clinicians manage their symptoms following guidelines that use the Centor score, 230 000 visits would be avoided in the United States each year and 8500 patients with GAS pharyngitis who would have received antibiotics would not be treated with them.

    Limitation

    Real-time information about the local incidence of GAS pharyngitis, which is necessary to calculate the new score, is not currently available.

    Conclusion

    A patient-driven approach to pharyngitis diagnosis that uses this new score could save hundreds of thousands of visits annually by identifying patients at home who are unlikely to require testing or treatment.

    Primary Funding Source

    Centers for Disease Control and Prevention and the National Library of Medicine, National Institutes of Health.

  • Document Type:
  • Collection(s):
  • Funding:
    1G08LM009778/LM/NLM NIH HHS/United States
    G08 LM009778/LM/NLM NIH HHS/United States
    K01HK000055/HK/PHITPO CDC HHS/United States
    P01HK000088/HK/PHITPO CDC HHS/United States
    R01 AI077780/AI/NIAID NIH HHS/United States
    R01 LM007677/LM/NLM NIH HHS/United States
    R01 LM007677/LM/NLM NIH HHS/United States
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