title: Participatory medicine: A home score for streptococcal pharyngitis enabled by real-time biosurveillance: a cohort study.
abstract: BACKGROUND
  Consensus guidelines recommend against testing or treating adults at low risk for group A streptococcal (GAS) pharyngitis.
  
  
  OBJECTIVE
  To help patients decide when to visit a clinician for the evaluation of sore throat.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  A national chain of retail health clinics.
  
  
  METHODS
  71 776 patients aged 15 years or older with pharyngitis who visited a clinic from September 2006 to December 2008.
  
  
  METHODS
  The authors created a score using information from patient-reported clinical variables plus the incidence of local disease and compared it with the Centor score and other traditional scores that require clinician-elicited signs.
  
  
  RESULTS
  If patients aged 15 years or older with sore throat did not visit a clinician when the new score estimated the likelihood of GAS pharyngitis to be less than 10% instead of having clinicians manage their symptoms following guidelines that use the Centor score, 230 000 visits would be avoided in the United States each year and 8500 patients with GAS pharyngitis who would have received antibiotics would not be treated with them.
  
  
  CONCLUSIONS
  Real-time information about the local incidence of GAS pharyngitis, which is necessary to calculate the new score, is not currently available.
  
  
  CONCLUSIONS
  A patient-driven approach to pharyngitis diagnosis that uses this new score could save hundreds of thousands of visits annually by identifying patients at home who are unlikely to require testing or treatment.
  
  
  BACKGROUND
  Centers for Disease Control and Prevention and the National Library of Medicine, National Institutes of Health.
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Fine
authors.forename: Victor
authors.initials: V
authors.lastname: Nizet
authors.forename: Kenneth D
authors.initials: KD
authors.lastname: Mandl
mesh_terms: D000293:Adolescent; D000328:Adult; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D009819:Office Visits / Q000706:statistics & numerical data; D010358:Patient Participation; D010612:Pharyngitis / Q000175:diagnosis* / Q000453:epidemiology; D011159:Population Surveillance / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D013290:Streptococcal Infections / Q000175:diagnosis* / Q000453:epidemiology; D013297:Streptococcus pyogenes; D014481:United States / Q000453:epidemiology; D055815:Young Adult