Improved diagnosis of group A streptococcal pharyngitis using real-time biosurveillance


Group A Streptococcal (GAS) pharyngitis, the most common bacterial cause of acute pharyngitis, causes more than half a billion cases annually worldwide. Treatment with antibiotics provides symptomatic benefit and reduces complications, missed work days and transmission. Physical examination alone is an unreliable way to distinguish GAS from other causes of pharyngitis, so the 4-point Centor score, based on history and physical, is used to classify GAS risk. Still, patients with pharyngitis are often misclassified, leading to inappropriate antibiotic treatment of those with viral disease and to under-treatment of those with bone fide GAS. One key problem, even when clinical guidelines are followed, is that diagnostic accuracy for GAS pharyngitis is affected by earlier probability of disease, which in turn is related to exposure. Point-of-care clinicians rarely have access to valuable biosurveillance-derived contextualizing information when making clinical management decisions.


The objective of this study was to measure the value of integrating real-time contemporaneous local disease incidence (biosurveillance) data with a clinical score, to more accurately identify patients with Group A Streptococcal (GAS) pharyngitis.

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December, 2010

June 27, 2019

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