Wigton R S, Connor J L, Centor R M
Arch Intern Med. 1986 Jan;146(1):81-3.
Use of existing decision rules could improve management of streptococcal pharyngitis, but the validity of such rules outside their original patient population is not known. We applied a four-item decision rule derived at the Medical College of Virginia, Richmond, to 516 patients at the University of Nebraska, Omaha, to test how accurately it would predict outcome of throat culture. After correction for differences in the prevalence of a positive culture (17% in Virginia, 26% in Nebraska), the rule closely predicted the frequency of positive cultures in five subgroups based on the presence of clinical findings. We conclude that this rule transported well to a different patient population and would have been useful in identifying patients with pharyngitis who had a high likelihood of throat cultures positive for group A streptococci.
使用现有的决策规则可以改善链球菌性咽炎的管理，但这些规则在其原始患者群体之外的有效性尚不清楚。我们将弗吉尼亚州里士满医学院得出的一项四项决策规则应用于奥马哈内布拉斯加大学的516名患者，以测试其预测咽拭子培养结果的准确性。在校正阳性培养患病率的差异（弗吉尼亚州为17%，内布拉斯加州为26%）后，该规则根据临床发现的存在情况，密切预测了五个亚组中阳性培养的频率。我们得出结论，该规则在不同患者群体中具有良好的适用性，并且在识别咽拭子培养A组链球菌呈阳性可能性高的咽炎患者方面会很有用。
