{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T03:26:49Z","timestamp":1785209209751,"version":"3.55.0"},"reference-count":45,"publisher":"Royal College of General Practitioners","issue":"693","license":[{"start":{"date-parts":[[2019,2,12]],"date-time":"2019-02-12T00:00:00Z","timestamp":1549929600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Gen Pract"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Centor and McIsaac scores are both used to diagnose group A beta-haemolytic streptococcus (GABHS) infection, but have not been compared through meta-analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To compare the performance of Centor and McIsaac scores at diagnosing patients with GABHS presenting to primary care with pharyngitis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and setting<\/jats:title><jats:p>A meta-analysis of diagnostic test accuracy studies conducted in primary care was performed using a novel model that incorporates data at multiple thresholds.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>MEDLINE, EMBASE, and PsycINFO were searched for studies published between January 1980 and February 2019. Included studies were: cross-sectional; recruited patients with sore throats from primary care; used the Centor or McIsaac score; had GABHS infection as the target diagnosis; used throat swab culture as the reference standard; and reported 2 \u00d7 2 tables across multiple thresholds. Selection and data extraction were conducted by two independent reviewers. QUADAS-2 was used to assess study quality. Summary receiver operating characteristic (SROC) curves were synthesised. Calibration curves were used to assess the transferability of results into practice.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ten studies using the Centor score and eight using the McIsaac score were included. The prevalence of GABHS ranged between 4% and 44%. The areas under the SROC curves for McIsaac and Centor scores were 0.7052 and 0.6888, respectively. The <jats:italic>P<\/jats:italic>-value for the difference (0.0164) was 0.419, suggesting the SROC curves for the tests are equivalent. Both scores demonstrated poor calibration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Both Centor and McIsaac scores provide only fair discrimination of those with and without GABHS, and appear broadly equivalent in performance. The poor calibration for a positive test result suggests other point-of-care tests are required to rule in GABHS; however, with both Centor and McIsaac scores, a score of \u22640 may be sufficient to rule out infection.<\/jats:p><\/jats:sec>","DOI":"10.3399\/bjgp20x708833","type":"journal-article","created":{"date-parts":[[2020,3,10]],"date-time":"2020-03-10T04:20:16Z","timestamp":1583814016000},"page":"e245-e254","source":"Crossref","is-referenced-by-count":45,"title":["Comparison of Centor and McIsaac scores in primary care: a meta-analysis over multiple thresholds"],"prefix":"10.3399","volume":"70","author":[{"given":"Brian H","family":"Willis","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dyuti","family":"Coomar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Baragilly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1987","published-online":{"date-parts":[[2020,3,9]]},"reference":[{"key":"2020081209344868000_70.693.e245.1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2014-006245"},{"issue":"427","key":"2020081209344868000_70.693.e245.2","first-page":"959","article-title":"Towards better diagnosis of throat infections (with group A beta-haemolytic streptococcus) in general practice","volume":"48","author":"Dagnelie","year":"1998","journal-title":"Br J Gen Pract"},{"key":"2020081209344868000_70.693.e245.3","doi-asserted-by":"crossref","unstructured":"Little P Hobbs FD Mant D Incidence and clinical variables associated with streptococcal throat infections: a prospective diagnostic cohort study Br J Gen Pract 2012 DOI: https:\/\/doi.org\/10.3399\/bjgp12X658322.","DOI":"10.3399\/bjgp12X658322"},{"key":"2020081209344868000_70.693.e245.4","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(05)70267-X"},{"key":"2020081209344868000_70.693.e245.5","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X8100100304"},{"issue":"1","key":"2020081209344868000_70.693.e245.6","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"},{"key":"2020081209344868000_70.693.e245.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2011.02.001"},{"issue":"4","key":"2020081209344868000_70.693.e245.8","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1007\/s00405-015-3872-6","article-title":"Clinical practice guideline: tonsillitis I. 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