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A Home Score for Streptococcal Pharyngitis FREE

[+] Article and Author Information

The full report is titled “Participatory Medicine: A Home Score for Streptococcal Pharyn-gitis Enabled by Real-Time Biosurveillance. A Cohort Study.” It is in the 5 November 2013 issue of Annals of Internal Medicine (volume 159, pages 577-583). The authors are A.M. Fine, V. Nizet, and K.D. Mandl.


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Ann Intern Med. 2013;159(9):I-24. doi:10.7326/0003-4819-159-9-201311050-00001
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What is the problem and what is known about it so far?

Most people with sore throat are infected with viruses that do not cause other problems and cannot be treated with existing drugs. Some people with sore throat are infected with a specific type of bacterium that can damage the heart, kidneys, and joints, although these problems occur rarely and antibiotics prevent them.

Experts recommend that most people with sore throat have a laboratory test to distinguish between viral and bacterial infection, although some agree that a test is not necessary in adults when the risk for bacterial infection is low enough. Some studies have created methods to measure risk by using information obtained when a clinician takes a patient's history and examines the patient, which requires an office visit.

Why did the researchers do this particular study?

To find a way to identify low-risk patients without an office visit.

Who was studied?

All adults with sore throat who visited one of the clinics in a national retail health chain during a 3-year period.

How was the study done?

During each visit, a clinician took the patient's history, examined the patient, and used traditional methods to calculate the risk for bacterial infection. The researchers then created a new method to calculate risk by combining information from each patient's history with information about the frequency of bacterial infection in the local population. Because the new method does not require a clinical examination, information about the patient could be collected during a telephone conversation.

What did the researchers find?

The new method for calculating risk was almost as accurate as traditional methods.

What were the limitations of the study?

Information about the frequency of bacterial infection is not available for many local populations. Also, if the new method replaces traditional methods, fewer patients with bacterial infection will receive antibiotics.

What are the implications of the study?

The new method could make many office visits for adults with sore throat unnecessary.

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