{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T16:50:17Z","timestamp":1790268617516,"version":"4.1.0"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,11,11]],"date-time":"2024-11-11T00:00:00Z","timestamp":1731283200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,11,11]],"date-time":"2024-11-11T00:00:00Z","timestamp":1731283200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005744","name":"Lastentautien Tutkimuss\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","award":["240070"],"award-info":[{"award-number":["240070"]}],"id":[{"id":"10.13039\/501100005744","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007083","name":"Orionin Tutkimuss\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007083","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003125","name":"Suomen Kulttuurirahasto","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003125","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007753","name":"University of Eastern Finland","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100007753","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>The Finnish Current Care Guideline recommends rapid antigen tests as the primary diagnostic tool for both adults and children with Centor score\u2009\u2265\u20093. We aimed to analyze the association of Centor score and rapid antigen test positivity of group A streptococcal pharyngitis (GAS) in Finnish children. We performed a retrospective single-center study from July 2019 to June 2022. We included all children aged 0\u201315 years based on ICD-10 diagnostic codes for acute pharyngitis. We manually extracted the data from the electronic healthcare records. We extracted the information on Centor score signs and symptoms, rapid antigen tests, throat cultures, and C-reactive protein (CRP) levels. Comparisons were made between different groups by calculating a difference of two proportions with 95% confidence intervals. A total of 464 children were included and rapid antigen tests were taken from 433 (93.3%). We did not detect any significant association between rapid antigen test positivity and Centor scores. Sensitivity of Centor score\u2009\u2265\u20093 for rapid antigen test positivity was 22.3 (95% confidence interval 17.3\u201327.9) and specificity 79.0% (72.4\u201384.8). Positive throat culture was found in 17.1% of the patients with negative rapid antigen test. Centor scores correlated positively with CRP levels, but elevated CRP did not predict positive antigen test results. <jats:italic>Conclusion<\/jats:italic>:\u00a0The Centor score alone does not seem to be of any utility in guiding the diagnosis of suspected streptococcal pharyngitis. Microbiological testing remains necessary for accurate diagnosis and CRP should not be used to differentiate viral and bacterial pharyngitis cases. \n<jats:table-wrap>\n              <jats:table>\n                <jats:tbody>\n                  <jats:tr>\n                    <jats:td align=\"left\">\n                      <jats:bold>What is Known:<\/jats:bold>\n                    <\/jats:td>\n                  <\/jats:tr>\n                  <jats:tr>\n                    <jats:td align=\"left\">\n                      <jats:italic>\u2022 The Centor score is a clinical prediction model for differentiating Group A streptococcal (GAS) pharyngitis from viral pharyngitis.<\/jats:italic>\n                    <\/jats:td>\n                  <\/jats:tr>\n                  <jats:tr>\n                    <jats:td align=\"left\">\n                      <jats:italic>\u2022 Finnish Current Care Guideline recommends rapid antigen testing in patients with Centor score<\/jats:italic>\u2009\u2265\u2009<jats:italic>3 for diagnosing GAS infections and antibiotics prescribed based on confirmed test results.<\/jats:italic>\n                    <\/jats:td>\n                  <\/jats:tr>\n                  <jats:tr>\n                    <jats:td align=\"left\">\n                      <jats:bold>What is New:<\/jats:bold>\n                    <\/jats:td>\n                  <\/jats:tr>\n                  <jats:tr>\n                    <jats:td align=\"left\">\n                      <jats:italic>\u2022 The Centor score alone does not seem to have any use in guiding the diagnosis of suspected streptococcal pharyngitis in children.<\/jats:italic>\n                    <\/jats:td>\n                  <\/jats:tr>\n                  <jats:tr>\n                    <jats:td align=\"left\">\n                      <jats:italic>\u2022 Microbiological testing remains necessary for accurate diagnosis in patients with sore throat.<\/jats:italic>\n                    <\/jats:td>\n                  <\/jats:tr>\n                <\/jats:tbody>\n              <\/jats:table>\n            <\/jats:table-wrap>\n          <\/jats:p>","DOI":"10.1007\/s00431-024-05863-2","type":"journal-article","created":{"date-parts":[[2024,11,11]],"date-time":"2024-11-11T16:39:55Z","timestamp":1731343195000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Centor scores associated poorly with rapid antigen test findings in children with sore throat"],"prefix":"10.1007","volume":"184","author":[{"given":"Johanna","family":"J\u00e4\u00e4skel\u00e4inen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjo","family":"Renko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilari","family":"Kuitunen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,11,11]]},"reference":[{"key":"5863_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1111\/J.1469-0691.2012.03766.X","volume":"18","author":"C Pelucchi","year":"2012","unstructured":"Pelucchi C, Grigoryan L, Galeone C et al (2012) Guideline for the management of acute sore throat. Clin Microbiol Infect 18:1\u201328. https:\/\/doi.org\/10.1111\/J.1469-0691.2012.03766.X","journal-title":"Clin Microbiol Infect"},{"issue":"5","key":"5863_CR2","doi-asserted-by":"publisher","first-page":"950","DOI":"10.1542\/PEDS.2006-3368","volume":"120","author":"MH Danchin","year":"2007","unstructured":"Danchin MH, Rogers S, Kelpie L et al (2007) Burden of acute sore throat and group A streptococcal pharyngitis in school-aged children and their families in Australia. Pediatrics 120(5):950\u2013957. https:\/\/doi.org\/10.1542\/PEDS.2006-3368","journal-title":"Pediatrics"},{"key":"5863_CR3","doi-asserted-by":"publisher","unstructured":"Shaikh N, Leonard E, Martin JM (2010) Prevalence of streptococcal pharyngitis and streptococcal carriage in children: a meta-analysis. Pediatrics 126 (3). https:\/\/doi.org\/10.1542\/PEDS.2009-2648","DOI":"10.1542\/PEDS.2009-2648"},{"issue":"7427","key":"5863_CR4","doi-asserted-by":"publisher","first-page":"1324","DOI":"10.1136\/BMJ.327.7427.1324","volume":"327","author":"S Zwart","year":"2003","unstructured":"Zwart S, Rovers MM, De Melker RA, Hoes AW (2003) Penicillin for acute sore throat in children: randomised, double blind trial. BMJ 327(7427):1324. https:\/\/doi.org\/10.1136\/BMJ.327.7427.1324","journal-title":"BMJ"},{"issue":"12","key":"5863_CR5","doi-asserted-by":"publisher","first-page":"5259","DOI":"10.1007\/S00431-023-05211-W","volume":"182","author":"R Pellegrino","year":"2023","unstructured":"Pellegrino R, Timitilli E, Verga MC et al (2023) Acute pharyngitis in children and adults: descriptive comparison of current recommendations from national and international guidelines and future perspectives. Eur J Pediatr 182(12):5259\u20135273. https:\/\/doi.org\/10.1007\/S00431-023-05211-W","journal-title":"Eur J Pediatr"},{"issue":"3","key":"5863_CR6","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1177\/0272989X8100100304\/ASSET\/0272989X8100100304.FP.PNG_V03","volume":"1","author":"RM Centor","year":"1981","unstructured":"Centor RM, Witherspoon JM, Dalton HP, Brody CE, Link K (1981) The diagnosis of strep throat in adults in the emergency room. Med Decis Making 1(3):239\u2013246. https:\/\/doi.org\/10.1177\/0272989X8100100304\/ASSET\/0272989X8100100304.FP.PNG_V03","journal-title":"Med Decis Making"},{"issue":"11","key":"5863_CR7","doi-asserted-by":"publisher","first-page":"847","DOI":"10.1001\/ARCHINTERNMED.2012.950","volume":"172","author":"AM Fine","year":"2012","unstructured":"Fine AM, Nizet V, Mandl KD (2012) Large-scale validation of the Centor and McIsaac scores to predict group A streptococcal pharyngitis. Arch Intern Med 172(11):847. https:\/\/doi.org\/10.1001\/ARCHINTERNMED.2012.950","journal-title":"Arch Intern Med"},{"key":"5863_CR8","unstructured":"Suomalaisen L\u00e4\u00e4k\u00e4riseuran Duodecimin SY yhdistyksen, SOSI ry:n ja K mikrobiologit ry:n asettama ty\u00f6ryhm\u00e4. Nielutulehdus: K\u00e4yp\u00e4 hoito-suositus, 2020. Suomalainen L\u00e4\u00e4k\u00e4riseura Duodecim. Published online 2020. Accessed 3 May 2024. www.kaypahoito.fi"},{"key":"5863_CR9","doi-asserted-by":"publisher","unstructured":"Spinks A, Glasziou PP, Del Mar CB. Antibiotics for sore throat. Cochrane Database of Systematic Reviews. Published online November 5, 2013. https:\/\/doi.org\/10.1002\/14651858.CD000023.pub4","DOI":"10.1002\/14651858.CD000023.pub4"},{"key":"5863_CR10","doi-asserted-by":"publisher","unstructured":"Gualtieri R, Verolet C, Mardegan C, et al. Amoxicillin vs. placebo to reduce symptoms in children with group A streptococcal pharyngitis: a randomized, multicenter, double-blind, non-inferiority trial. Eur J Pediatr. Published online August 31, 2024. https:\/\/doi.org\/10.1007\/s00431-024-05705-1","DOI":"10.1007\/s00431-024-05705-1"},{"issue":"1","key":"5863_CR11","doi-asserted-by":"publisher","first-page":"503","DOI":"10.1186\/s12887-024-04982-x","volume":"24","author":"J J\u00e4\u00e4skel\u00e4inen","year":"2024","unstructured":"J\u00e4\u00e4skel\u00e4inen J, Renko M, Kuitunen I (2024) The impact of national guidelines on the diagnostics of sore throat in children. BMC Pediatr 24(1):503. https:\/\/doi.org\/10.1186\/s12887-024-04982-x","journal-title":"BMC Pediatr"},{"key":"5863_CR12","doi-asserted-by":"publisher","unstructured":"Roggen I, Van Berlaer G, Gordts F, Pierard D, Hubloue I (2013) Centor criteria in children in a paediatric emergency department: for what it is worth. 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