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A clinical prediction model did well in diagnosing paediatric group A β-haemolytic streptococcal pharyngitis
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 QUESTION: In children with suspected group A β-haemolytic streptococcal (GABHS) pharyngitis, how well does a prediction model predict a positive throat culture?

Design

1 year validation of a previously derived prediction model.

Setting

Paediatric emergency department and 2 paediatric outpatient clinics in Wilmington, Delaware, USA.

Patients

587 children (mean age 6.8 y, 51% girls) who had signs and symptoms of acute pharyngitis. Exclusion criteria were antibiotic treatment within 5 days of enrollment.

Description of prediction guide

During the clinical evaluation, the examining physician recorded 4 variables from the tested model: cervical lymphadenopathy, tonsillar swelling (2 category severity scale: absent or mild and moderate or severe), coryza, and scarletiniform rash (present or absent). 2 tonsillopharyngeal specimens were collected for each patient for serotyping (diagnostic standard) and a rapid streptococcal antigen detection test. Furthermore, the physician made a subjective probability estimate for …

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