Participatory medicine: A home score for streptococcal pharyngitis enabled by real-time biosurveillance: a cohort study.
Participatory medicine: A home score for streptococcal pharyngitis enabled by real-time biosurveillance: a cohort study.
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DOI：
10.7326/0003-4819-159-9-201311050-00003
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发表时间：
2013-11-05
影响因子：
39.2
通讯作者：
Mandl KD
中科院分区：
文献类型：
--
作者：
Fine AM;Nizet V;Mandl KD
共识指南建议，A组链球菌（GAS）咽炎低风险的成年人既不进行检测也不进行治疗，以帮助患者决定何时去看临床医生评估喉咙痛。回顾性队列研究。一家全国连锁的零售诊所。2006年9月至2008年12月期间，71 776例年龄在15岁或以上的咽炎患者就诊于诊所。作者使用患者报告的临床变量加上局部疾病的发生率的信息创建了一个评分，并将其与Centor评分和其他需要临床医生引发体征的传统评分进行了比较。如果年龄在15岁或以上的咽喉痛患者在新评分估计GAS咽炎的可能性小于10%时没有去看临床医生，而不是让临床医生按照使用Centor评分的指南来管理他们的症状，在美国，每年将避免23万次就诊，8500名本应接受抗生素治疗的GAS咽炎患者将不必接受治疗。对待他们。计算新评分所需的GAS咽炎当地发病率的实时信息目前不可用。使用这种新评分的患者驱动的咽炎诊断方法每年可以通过识别不太可能需要检测或治疗的患者来节省数十万次访问。疾病控制和预防中心和国家医学图书馆，国立卫生研究院。
Consensus guidelines recommend that adults at low risk for group A streptococcal (GAS) pharyngitis be neither tested nor treated To help patients decide when to visit a clinician for the evaluation of sore throat. Retrospective cohort study. A national chain of retail health clinics. 71 776 patients aged 15 years or older with pharyngitis who visited a clinic from September 2006 to December 2008. 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. 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. Real-time information about the local incidence of GAS pharyngitis, which is necessary to calculate the new score, is not currently available. 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. Centers for Disease Control and Prevention and the National Library of Medicine, National Institutes of Health.
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影响因子：
39.2
作者：
Snow, V;Mottur-Pilson, C;Hoffman, LR
通讯作者：
Hoffman, LR
影响因子：
158.5
作者：
WASSON, JH;SOX, HC;GOLDMAN, L
通讯作者：
GOLDMAN, L
影响因子：
39.2
作者：
Reilly, BM;Evans, AT
通讯作者：
Evans, AT
影响因子：
120.7
作者：
McIsaac, WJ;Kellner, JD;Low, DE
通讯作者：
Low, DE
影响因子：
--
作者：
Fine, Andrew M.;Nizet, Victor;Mandl, Kenneth D.
通讯作者：
Mandl, Kenneth D.