{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T12:49:48Z","timestamp":1768999788072,"version":"3.49.0"},"reference-count":10,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,10,20]],"date-time":"2020-10-20T00:00:00Z","timestamp":1603152000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Our primary aim was to validate the Liverpool Peritonsillar abscess Score (LPS) externally in a new patient cohort. Our secondary aim was to modify the LPS in the light of the COVID\u201019 pandemic to produce a no\u2010examination variant for use in this instance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Prospective multicentre external validation study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Six different secondary care institutions across the United Kingdom.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Patients over 16\u00a0years old who were referred to ENT with any uncomplicated sore throat such a tonsillitis or peritonsillar abscess (PTA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Sensitivity, specificity, positive predictive value and negative predictive value for both the original LPS model and the modified model for COVID\u201019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The LPS model had sensitivity and specificity calculated at 98% and 79%, respectively. The LPS has a high negative predictive value (NPV) of 99%. The positive predictive value (PPV) was slightly lower at 63%. Receiver operating characteristic (ROC) curve, including the area under the curve (AUROC), was 0.888 which indicates very good accuracy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>External validation of the LPS against an independent geographically diverse population yields high NPV. This may support non\u2010specialist colleagues who may have concerns about mis\u2010diagnosing a PTA. The COVID\u201019 modification of the LPS has a similar NPV, which may be of use where routine oral examination is to be avoided during the COVID\u201019 pandemic.<\/jats:p><\/jats:sec>","DOI":"10.1111\/coa.13652","type":"journal-article","created":{"date-parts":[[2020,9,30]],"date-time":"2020-09-30T19:46:55Z","timestamp":1601495215000},"page":"229-233","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["A prospective multicentre external validation study of the Liverpool Peritonsillar abscess Score (LPS) with a no\u2010examination COVID\u201019 modification"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0028-3859","authenticated-orcid":false,"given":"David","family":"Selwyn","sequence":"first","affiliation":[{"name":"Bradford Royal Infirmary Bradford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ding","family":"Yang","sequence":"additional","affiliation":[{"name":"Royal Stoke University Hospital Stoke\u2010on\u2010Trent UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9692-646X","authenticated-orcid":false,"given":"Elliot","family":"Heward","sequence":"additional","affiliation":[{"name":"Stepping Hill Hospital Stockport UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashwin","family":"Kerai","sequence":"additional","affiliation":[{"name":"Arrowe Park Hospital Wirral UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elinor","family":"Thompson","sequence":"additional","affiliation":[{"name":"Arrowe Park Hospital Wirral UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abulgasem","family":"Shommakhi","sequence":"additional","affiliation":[{"name":"Arrowe Park Hospital Wirral UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott","family":"Faulkner","sequence":"additional","affiliation":[{"name":"Arrowe Park Hospital Wirral UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6950-4026","authenticated-orcid":false,"given":"Richard","family":"Siau","sequence":"additional","affiliation":[{"name":"Arrowe Park Hospital Wirral UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6838-4499","authenticated-orcid":false,"given":"Hussein","family":"Walijee","sequence":"additional","affiliation":[{"name":"Arrowe Park Hospital Wirral UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6515-8058","authenticated-orcid":false,"given":"Tom","family":"Hampton","sequence":"additional","affiliation":[{"name":"Mersey ENT Research Collaborative (MERC) Merseyside UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5174-8359","authenticated-orcid":false,"given":"Dorota","family":"Chudek","sequence":"additional","affiliation":[{"name":"Royal Liverpool University Hospital Liverpool UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Supriya","family":"Singhera","sequence":"additional","affiliation":[{"name":"Wythenshawe Hospital Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1416-8181","authenticated-orcid":false,"given":"Waqas","family":"Din","sequence":"additional","affiliation":[{"name":"Bradford Royal Infirmary Bradford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6489-204X","authenticated-orcid":false,"given":"Andrew S.","family":"Lau","sequence":"additional","affiliation":[{"name":"Arrowe Park Hospital Wirral UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,10,20]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.13233"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiac.2014.07.018"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1308\/003588414X13946184900363"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.13290"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa023153"},{"key":"e_1_2_9_7_1","unstructured":"ENTUK. 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