January 1986

Transportability of a Decision Rule for the Diagnosis of Streptococcal Pharyngitis

Author Affiliations

From the Section of General Medicine, Department of Medicine, University of Nebraska College of Medicine, Omaha (Drs Wigton and Connor); and the Medical College of Virginia, Richmond (Dr Centor).

Arch Intern Med. 1986;146(1):81-83. doi:10.1001/archinte.1986.00360130103014

Use of existing decision rules could improve management of streptococcal pharyngitis, but the validity of such rules outside their original patient population is not known. We applied a four-item decision rule derived at the Medical College of Virginia, Richmond, to 516 patients at the University of Nebraska, Omaha, to test how accurately it would predict outcome of throat culture. After correction for differences in the prevalence of a positive culture (17% in Virginia, 26% in Nebraska), the rule closely predicted the frequency of positive cultures in five subgroups based on the presence of clinical findings. We conclude that this rule transported well to a different patient population and would have been useful in identifying patients with pharyngitis who had a high likelihood of throat cultures positive for group A streptococci.

(Arch Intern Med 1986;146:81-83)