Monto et al developed a predictive index for patients with upper respiratory tract infections due to picornaviruses. The authors are from the University of Michigan and Applied Health Outcomes (Tampa, Florida).
Parameters:
(1) rhinorrhea (uses 2 or more tissues per hour)
(2) nasal congestion (complete or bothersome blockage of 1 or both nostrils, or the need for a decongestant)
(3) sore throat (bothersome sore throat, or difficulty swallowing, or the need for gargles and pain medication)
(4) myalgia (bothersome muscle aches or need for analgesic medication for muscle aches)
(5) body temperature (fever)
|
Parameter |
Finding |
Points |
|
rhinorrhea |
present |
4 |
|
|
absent |
0 |
|
nasal congestion |
present |
2 |
|
|
absent |
0 |
|
sore throat |
present |
1 |
|
|
absent |
0 |
|
myalgia |
present |
-1 |
|
|
absent |
0 |
|
body temperature |
> 37.5°C |
-2 |
|
|
<= 37.5 |
0 |
where:
• Items with positive points favor picornavirus infection, while negative points are assigned to findings seen with other conditions.
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: -3
• maximum score: +7
• The higher the score the higher the probability of a picornaviral infection.
|
Score |
Probability of Picornavirus Infection |
|
-3 |
15% |
|
-2 |
5% |
|
-1 |
16% |
|
0 |
25% |
|
+1 |
31% |
|
+2 |
37% |
|
+3 |
43% |
|
+4 |
48% |
|
+5 |
59% |
|
+6 |
62% |
|
+7 |
69% |
Performance:
• The score does not strike me as being terribly predictive. It might help triage patients but would require a more specific for diagnosis.
• It can help distinguish patient more likely to have influenza.
Limitations:
• The selection of the study population could affect overall performance.
Specialty: Infectious Diseases, Pedatrics
