Usefulness of a 'scorecard' in managing patients with sore throat

January 01, 0001

Usefulness of a 'scorecard' in managing patients with sore throat

The aim of this study from a solo family practice in rural New South Wales, Australia was to evaluate the usefulness of a clinical scorecard in managing sore throat in general practice. Validation study of scorecard for sore throat with a throat swab culture used as the 'gold standard'. Patients from the age of 5 years and above presenting with the main symptom of a sore throat, and who had not had any antibiotic treatment in the previous two weeks, were invited to participate in the study. The doctor completed a scorecard for each patient participating and took a throat swab for culture. Adult patients (greater than 16 yrs) were asked to complete a patient satisfaction questionnaire, while guardians accompanying children (5 yr to less than 16 yrs old) were asked to complete a similar, guardian questionnaire.

The scorecard has a sensitivity of 93.33%, a specificity of 63.16%, a positive predictive value of 50% and a negative predictive value of 96%. The sensitivity is better than other sore throat scorecards that have been published but with a slightly lower specificity. There was a high level of patient trust in the scorecard (85.8% agreement). Patients also trusted their doctor's judgement based on the scorecard (90.6% agreement).

The researchers concluded: "As the scorecard has a high sensitivity but only a moderate specificity, this means that it is more reliable for negative results, i.e. when the result suggests a viral infection. When the result favours a bacterial sore throat, then a high sensitivity can mean that there are a number of false positives. GPs can be confident in withholding antibiotics when the scorecard indicates a viral infection."

Another possible way to appropriately reduce antibiotic use.

For the full abstract, click here.

Asia Pacific Family Medicine 29 July 2010 © 1999-2010 BioMed Central Ltd
The usefulness of a clinical 'scorecard' in managing patients with sore throat in general practice. Tony MO Bakare and Peter Schattner.

Category: R. Respiratory. Keywords: scorecard, clinical, managing, sore throat, cohort study, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 3 September 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.