{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:49:16Z","timestamp":1760028556476,"version":"3.41.2"},"reference-count":30,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,7,1]]},"abstract":"\n BACKGROUND AND OBJECTIVES:<\/jats:title>\n Identifying symptomatic patients who are at low risk for group A streptococcal (GAS) pharyngitis could reduce unnecessary visits and antibiotic use. The accuracy with which patients and parents report signs and symptoms of GAS has not been studied. Our objectives were to measure agreement between patient or parent and physician-reported signs and symptoms of GAS and to evaluate the performance of a modified Centor score, based on patient or parent and physician reports, for identifying patients at low risk for GAS pharyngitis.<\/jats:p>\n <\/jats:sec>\n \n METHODS:<\/jats:title>\n Children 3 to 21 years old presenting to a single tertiary care emergency department between October 2013 and January 2015 were included if they complained of a sore throat and were tested for GAS. Patients or parents and physicians completed surveys assessing signs and symptoms to determine a modified age-adjusted Centor score for GAS. We evaluated the overall agreement and \u03ba between patient or parent and physician-reported signs and symptoms and compared the performance of the scores based on assessments by patients or parents and physicians and the risk of GAS.<\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n Of 320 patients enrolled, 107 (33%) tested GAS positive. Agreement was higher for symptoms (fever [agreement = 82%, \u03ba = 0.64] and cough [72%, 0.45]) than for signs (exudate [80%, 0.41] and tender cervical nodes [73%, 0.18]). Agreement was highest when no signs and symptoms contained in the Centor score were present (94%, \u03ba = 0.61). The proportion of patients testing GAS positive rose as the modified Centor score increased.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS:<\/jats:title>\n For identifying GAS pharyngitis, patients or parents and physicians showed moderate to substantial agreement for 3 of 4 key pharyngitis signs and symptoms.<\/jats:p>\n <\/jats:sec>","DOI":"10.1542\/peds.2016-0317","type":"journal-article","created":{"date-parts":[[2016,6,8]],"date-time":"2016-06-08T09:32:06Z","timestamp":1465378326000},"source":"Crossref","is-referenced-by-count":12,"title":["Patient and Parent-Reported Signs and Symptoms for Group A Streptococcal Pharyngitis"],"prefix":"10.1542","volume":"138","author":[{"given":"Christina","family":"Lindgren","sequence":"first","affiliation":[{"name":"Division of Emergency Medicine and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark I.","family":"Neuman","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine and"},{"name":"Departments of Pediatrics and Emergency Medicine, Harvard Medical School, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael C.","family":"Monuteaux","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine and"},{"name":"Departments of Pediatrics and Emergency Medicine, Harvard Medical School, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth D.","family":"Mandl","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine and"},{"name":"Departments of Pediatrics and Emergency Medicine, Harvard Medical School, Boston, Massachusetts"},{"name":"Computational Health Informatics Program, Boston Children\u2019s Hospital, Boston, Massachusetts; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew M.","family":"Fine","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine and"},{"name":"Departments of Pediatrics and Emergency Medicine, Harvard Medical School, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2016,7,1]]},"reference":[{"issue":"4","key":"2021120905000391700_B1","first-page":"e145","article-title":"Cost-effectiveness of pharmacist-provided treatment of adult pharyngitis.","volume":"18","author":"Klepser","year":"2012","journal-title":"Am J Manag Care"},{"issue":"11","key":"2021120905000391700_B2","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1016\/S1473-3099(05)70267-X","article-title":"The global burden of group A streptococcal diseases.","volume":"5","author":"Carapetis","year":"2005","journal-title":"Lancet Infect Dis"},{"issue":"3","key":"2021120905000391700_B3","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1177\/0272989X8100100304","article-title":"The diagnosis of strep throat in adults in the emergency room","volume":"1","author":"Centor","year":"1981","journal-title":"Med Decis Making"},{"issue":"6","key":"2021120905000391700_B4","doi-asserted-by":"crossref","first-page":"345","DOI":"10.7326\/0003-4819-155-6-201109200-00002","article-title":"Improved diagnostic accuracy of group A streptococcal pharyngitis with use of real-time biosurveillance.","volume":"155","author":"Fine","year":"2011","journal-title":"Ann Intern Med"},{"issue":"11","key":"2021120905000391700_B5","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1001\/archinternmed.2012.950","article-title":"Large-scale validation of the Centor and McIsaac scores to predict group A streptococcal pharyngitis.","volume":"172","author":"Fine","year":"2012","journal-title":"Arch Intern Med"},{"issue":"13","key":"2021120905000391700_B6","doi-asserted-by":"crossref","first-page":"1587","DOI":"10.1001\/jama.291.13.1587","article-title":"Empirical validation of guidelines for the management of pharyngitis in children and adults.","volume":"291","author":"McIsaac","year":"2004","journal-title":"JAMA"},{"issue":"2","key":"2021120905000391700_B7","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1086\/340949","article-title":"Practice guidelines for the diagnosis and management of group A streptococcal pharyngitis.","volume":"35","author":"Bisno","year":"2002","journal-title":"Clin Infect Dis"},{"issue":"7","key":"2021120905000391700_B8","first-page":"811","article-title":"The validity of a sore throat score in family practice","volume":"163","author":"McIsaac","year":"2000","journal-title":"CMAJ."},{"issue":"1","key":"2021120905000391700_B9","first-page":"75","article-title":"A clinical score to reduce unnecessary antibiotic use in patients with sore throat","volume":"158","author":"McIsaac","year":"1998","journal-title":"CMAJ."},{"issue":"5","key":"2021120905000391700_B10","first-page":"383","article-title":"Diagnosis and treatment of streptococcal pharyngitis","volume":"79","author":"Choby","year":"2009","journal-title":"Am Fam Physician"},{"issue":"9","key":"2021120905000391700_B11","doi-asserted-by":"crossref","first-page":"577","DOI":"10.7326\/0003-4819-159-9-201311050-00003","article-title":"Participatory medicine: a home score for streptococcal pharyngitis enabled by real-time biosurveillance: a cohort study.","volume":"159","author":"Fine","year":"2013","journal-title":"Ann Intern Med"},{"key":"2021120905000391700_B12","volume-title":"Zitelli and Davis\u2019 Atlas of Pediatric Physical Diagnosis.","author":"Zitelli","year":"2012","edition":"6th ed"},{"issue":"10","key":"2021120905000391700_B13","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1093\/cid\/cis847","article-title":"Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America","volume":"55","author":"Shulman","year":"2012","journal-title":"Clin Infect Dis"},{"issue":"7","key":"2021120905000391700_B14","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1056\/NEJMcp1009126","article-title":"Clinical practice. 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