Attia et al reported a predictive model for pharyngitis in children associated with Streptococcus pyogenes. This is based on a previously published clinical decision rule. The authors are from Alfred I duPont Hospital for Children in Wilmington and Thomas Jefferson Medical College.
Patient selection: child with pharyngitis (range 2.8 to 10.6 years)
Parameters:
(1) tonsillar swelling
(2) cervical lymphadenopathy
(3) scarletiniform rash
(4) coryza
Parameter
Finding
Points
tonsillar swelling
no
0
yes
1
cervical lymphadenopathy
no
0
yes
1
scarletiniform rash
no
0
yes
2
coryza
yes
0
no
1
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 5
• A score >= 4 was specific (98%) but not sensitive (17%).
• A score of 0 had less than 15% chance of a positive culture.
Performance:
• The area under the ROC curve is 0.67.
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