To the Editor.—
The data presented in the article by Poses et al1 in the Aug 16 issue of The Journal on probability estimates for patients with sore throats do not clearly support the conclusions drawn by the authors.First, as the study was designed, there is no way to prove that the discrepancy between clinical diagnosis and culture results was entirely due to overdiagnosis and not, at least in part, to false-negative cultures. Ideally, serial titers should have been performed. It would have been helpful if the methodology had been described so that there could be some confidence that swabs were properly taken, plating was not delayed, and incubation was appropriate. The fact that only 15 positive cultures were found in one year should raise the suspicion that techniques may have been inadequate.Second, the design of the study does not permit an answer to the major question
Forsyth RA. Physicians' Accuracy for Diagnosing Sore Throats. JAMA. 1986;255(6):745–746. doi:10.1001/jama.1986.03370060059012
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