Large-Scale Validation of the Centor and McIsaac Scores to Predict Group A Streptococcal Pharyngitis
Large-Scale Validation of the Centor and McIsaac Scores to Predict Group A Streptococcal Pharyngitis
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DOI：
10.1001/archinternmed.2012.950
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发表时间：
2012-06-11
影响因子：
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通讯作者：
Mandl, Kenneth D.
中科院分区：
文献类型：
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作者：
Fine, Andrew M.;Nizet, Victor;Mandl, Kenneth D.
背景资料：Centor和McIsaac评分指导了对咽喉痛患者进行A组链球菌（GAS）咽炎的检测和治疗，但它们是在相对较小的样本上得出的。我们进行一个大的，地理上不同的population.Methods：我们分析了收集到的数据，从206 870例患者3岁或以上的美国国家零售健康连锁店从2006年9月1日，2008年12月1日，喉咙痛。主要结果测量是根据Centor和McIsaac评分，GAS咽炎检测阳性的患者比例结果：15岁以上的患者中，23%的患者在15岁以下的患者中。（95% CI，22%-23%）GAS检测阳性，包括7%（95% CI，7%-8%）Centor评分为0的患者; 12%（95% CI，11%-12%）Centor评分为1的患者; 21%（95% CI，21%-22%）; 38%（95% CI，38%-39%）; 57%（95% CI，56%-58%）。对于3岁或以上的患者，27%（95% CI，27%-27%）GAS检测阳性，包括8%（95% CI，8%-9%）McIsaac评分为0的检测阳性者; 14%（95% CI，13%-14%）McIsaac评分为1的患者; 23%（95% CI，23%-23%）; 37%（95% CI，37%-37%）; 55%（95% CI，55%-56%）。我们的零售健康链衍生的概率和以前的reports.Conclusion之间的95%CI重叠：我们的研究验证了Centor和McIsaac分数，并更精确地分类与疼痛的喉咙零售健康链的患者之间的GAS感染的风险。
Background: The Centor and McIsaac scores guide testing and treatment for group A streptococcal (GAS) pharyngitis in patients presenting with a sore throat, but they were derived on relatively small samples. We perform a national-scale validation of the prediction models on a large, geographically diverse population.Methods: We analyzed data collected from 206 870 patients 3 years or older who presented with a painful throat to a United States national retail health chain from September 1, 2006, to December 1, 2008. Main outcome measures were the proportions of patients testing positive for GAS pharyngitis according to the Centor and McIsaac scores (both scales, 0-4).Results: For patients 15 years or older, 23% (95% CI, 22%-23%) tested positive for GAS, including 7% (95% CI, 7%-8%) of those with a Centor score of 0; 12% (95% CI, 11%-12%) of those with a Centor score of 1; 21% (95% CI, 21%-22%) of those with a Centor score of 2; 38% (95% CI, 38%-39%) of those with a Centor score of 3; and 57% (95% CI, 56%-58%) of those with a Centor score of 4. For patients 3 years or older, 27% (95% CI, 27%-27%) tested positive for GAS, including 8% (95% CI, 8%-9%) of those testing positive with a McIsaac score of 0; 14% (95% CI, 13%-14%) of those with a McIsaac score of 1; 23% (95% CI, 23%-23%) of those with a McIsaac score of 2; 37% (95% CI, 37%-37%) of those with a McIsaac score of 3; and 55% (95% CI, 55%-56%) of those with a McIsaac score of 4. The 95% CIs overlapped between our retail health chain-derived probabilities and the prior reports.Conclusion: Our study validates the Centor and McIsaac scores and more precisely classifies risk of GAS infection among patients presenting with a painful throat to a retail health chain.