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- Title
Group A Streptococcal Tonsillopharyngitis: The Diagnostic Power of the Centor and McIsaac Clinical Prediction Models at Different Pre-probability.
- Authors
Büyükdinç, Melda Dibek; Başak, Hatice Sema; Çelik, Elif; Avcil, Mücahit; Telli, Murat; Türe, Mevlüt; Başak, Okay
- Abstract
Background: The power of diagnostic tests is affected by pre-test probability, and clinical prediction models must be validated in different populations. The aim of this study was to determine the diagnostic value of symptoms and signs for group A Streptococcus tonsillopharyngitis and diagnostic power of Centor and Mclsaac criteria in a patient population with different pre-probability. Methods: The study was conducted between September 2019 and February 2020 in Adnan Menderes University Hospital's outpatient clinics. A total of 405 patients older than 36 months who presented with one of the complaints of acute tonsillopharyngitis participated in the study. Throat swab samples were taken from each patient. The diagnostic value of symptoms and signs was determined by performing univariate analysis and multiple logistic regression analysis. Results: The mean age of 405 patients was 24.7 (3-81 years). While group A Streptococcus positivity was 7.9% over the age of 3, the frequency of group A Streptococcus was 16.8% in children under the age of 15 and 4.7% in adolescents and adults. Group A Streptococcus positivity was 45.8% in those with a Centor score of 4 and 35.7% in those with a Mclsaac score of 4-5. In regression analysis, only 4 criteria included in the Centor score entered the model (P < .05). Conclusions: Centor and McIsaac clinical prediction models were found to be valid in our patient group with low group A Streptococcus positivity. However, although the diagnostic power of both clinical prediction models does not change in the patient population with low group A Streptococcus positivity, they cannot increase the posttest probability above 40-50%.
- Subjects
PREDICTION models; MULTIPLE regression analysis; LOGISTIC regression analysis; RHEUMATIC fever; OLDER patients; UNIVARIATE analysis
- Publication
ENT Updates, 2022, Vol 12, Issue 1, p56
- ISSN
2149-7109
- Publication type
Article
- DOI
10.5152/entupdates.2022.21071