A Biosurveillance-driven Home Score to Guide Strep Pharyngitis Treatment

Andrew Fine, Victor Nizet, Kenneth Mandl


Adults at low risk for Group A streptococcal (GAS) pharyngitis should neither be tested nor treated, yet millions annually seek care. We derive and validate a 'home score' to estimate a patient's GAS risk based on history and real-time local biosurveillance, and compare its accuracy to traditional models. Data included 110,208 patients seen at a national retail health chain. Using a 0.10 home score cutoff extrapolates to 230,000 saved visits annually and 8500 additional missed cases (0.20: 2.9M visits saved, 320,000 additional missed). A patient-centric approach could save millions of visits annually by identifying low-risk patients in the pre-visit setting.

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DOI: http://dx.doi.org/10.5210/ojphi.v5i1.4561

Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org