Diagnosis of acute tonsillopharyngitis in primary care: a new approach for low-resource settings

Alper, Züleyha; Uncu, Yeşim; Akalın, Halis; Ercan, İlker; Sınırtaş, Melda; Bilgel, Nazan

doi:10.1179/1973947813y.0000000071

Cited by 14 publications

(19 citation statements)

References 24 publications

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“…The searches identified 80 citations. The full selection process (outlined in Figure 1) resulted in 18 studies 2,6,11,12,[24][25][26][27][28][29][30][31][32][33][34][35][36][37] being included in the review; 10 of these used the Centor score 2,11,12,[24][25][26][27][28][29][30][31] and eight used the McIsaac score. 6,11,12,[32][33][34][35][36][37] Only one study -reported by Fine et al 11,12 -provided sufficient data to allow a direct comparison between the two tests.…”

Section: Study Selectionmentioning

confidence: 99%

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Comparison of Centor and McIsaac scores in primary care: a meta-analysis over multiple thresholds

Willis

Coomar

Baragilly³

2020

Br J Gen Pract

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BackgroundCentor and McIsaac scores are both used to diagnose group A beta-haemolytic streptococcus (GABHS) infection, but have not been compared through meta-analysis.AimTo compare the performance of Centor and McIsaac scores at diagnosing patients with GABHS presenting to primary care with pharyngitis.Design and settingA meta-analysis of diagnostic test accuracy studies conducted in primary care was performed using a novel model that incorporates data at multiple thresholds.MethodMEDLINE, EMBASE, and PsycINFO were searched for studies published between January 1980 and February 2019. Included studies were: cross-sectional; recruited patients with sore throats from primary care; used the Centor or McIsaac score; had GABHS infection as the target diagnosis; used throat swab culture as the reference standard; and reported 2 × 2 tables across multiple thresholds. Selection and data extraction were conducted by two independent reviewers. QUADAS-2 was used to assess study quality. Summary receiver operating characteristic (SROC) curves were synthesised. Calibration curves were used to assess the transferability of results into practice.ResultsTen studies using the Centor score and eight using the McIsaac score were included. The prevalence of GABHS ranged between 4% and 44%. The areas under the SROC curves for McIsaac and Centor scores were 0.7052 and 0.6888, respectively. The P-value for the difference (0.0164) was 0.419, suggesting the SROC curves for the tests are equivalent. Both scores demonstrated poor calibration.ConclusionBoth Centor and McIsaac scores provide only fair discrimination of those with and without GABHS, and appear broadly equivalent in performance. The poor calibration for a positive test result suggests other point-of-care tests are required to rule in GABHS; however, with both Centor and McIsaac scores, a score of ≤0 may be sufficient to rule out infection.

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Section: Study Selectionmentioning

confidence: 99%

“…Full study characteristics are detailed in Table 1. Of those studies using the Centor score, eight were conducted in Europe 2, [24][25][26][27][29][30][31] and two in the US. 11,12,28 Of those studies using the McIsaac score, three were conducted in Europe, 32,33,36 four in North America, 6,11,12,35,37 and one in Australia.…”

Section: Study Characteristicsmentioning

confidence: 99%

Comparison of Centor and McIsaac scores in primary care: a meta-analysis over multiple thresholds

Willis

Coomar

Baragilly³

2020

Br J Gen Pract

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“…"Sore throat" symptoms, including pharyngitis, are common reasons for seeking medical assistance in primary care and emergency services,1 accounting for 12 million consultations a year in the United States in 2006, with a significant impact to the healthcare system 23…”

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confidence: 99%

“…Os sintomas "dor de garganta", incluindo as faringites, são causas comuns de procura do atendimento médico nos serviços de atenção primária e de urgência,1 sendo responsáveis nos Estados Unidos por 12 milhões de atendimentos ao ano, em 2006, com importante impacto para o sistema de saúde 2. Embora a maioria dos casos de faringites seja de etiologia viral (50-80%), as bactérias estão implicadas em cerca de 5-30% dos casos 3…”

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Diagnosing streptococcal pharyngotonsillitis in children and adolescents: the limitations of the clinical features

Passos¹

2014

Rev. paul. pediatr.

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Rapid antigen detection test for group A streptococcus in children with pharyngitis

Cohen

Bertille

Cohen

et al. 2016

Cochrane Database of Systematic Reviews

106

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Diagnosis of acute tonsillopharyngitis in primary care: a new approach for low-resource settings

Abstract: Centor criteria could be safely used to reduce unnecessary antibiotic usage for tonsillopharyngitis in developing countries.

Cited by 14 publications

References 24 publications

Comparison of Centor and McIsaac scores in primary care: a meta-analysis over multiple thresholds

Comparison of Centor and McIsaac scores in primary care: a meta-analysis over multiple thresholds

Diagnosing streptococcal pharyngotonsillitis in children and adolescents: the limitations of the clinical features

Rapid antigen detection test for group A streptococcus in children with pharyngitis

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