Centor R M, Witherspoon J M, Dalton H P, Brody C E, Link K
Med Decis Making. 1981;1(3):239-46. doi: 10.1177/0272989X8100100304.
Adult patients who presented to an urban emergency room complaining of a sore throat had cultures and clinical information recorded. Models were constructed, using logistic regression analysis, of both a positive culture for Group A beta streptococcus and a positive guess by a resident. The model of a positive culture consisted of four variables--tonsillar exudates, swollen tender anterior cervical nodes, lack of a cough, and history of fever. Patients with all 4 variables had a 56% probability of a positive culture; 3 variables, 32%; 2 variables, 15%; 1 variable, 6.5%; and 0 variables, 2.5%. The model of a positive guess by a resident demonstrated an over-reliance on physical exam and an underuse of history. The model of a positive culture allows stratification of patients to assist clinicians in the management strategies.
到城市急诊室就诊并主诉咽痛的成年患者，其培养结果和临床信息均有记录。运用逻辑回归分析构建了A组β溶血性链球菌培养阳性以及住院医师阳性猜测的模型。培养阳性的模型由四个变量组成——扁桃体渗出物、颈前淋巴结肿大压痛、无咳嗽以及发热史。具备所有四个变量的患者培养阳性概率为56%；具备三个变量的患者为32%；具备两个变量的患者为15%；具备一个变量的患者为6.5%；不具备任何变量的患者为2.5%。住院医师阳性猜测的模型显示出对体格检查的过度依赖以及对病史的利用不足。培养阳性的模型可对患者进行分层，以协助临床医生制定管理策略。
