WASHINGTON (AP) — Debating whether to seek a strep test for that sore throat? Researchers are developing a home scorecard that aims to prevent thousands of unnecessary trips to the doctor for this common complaint.
Every year, more than 12 million people with sore throats go to doctors' offices. Usually the culprit is a virus they just have to wait out.
In fact, the risk of strep throat is low enough for adults that doctors may skip testing them after running down a list of symptoms.
“If you could know that your risk was low enough that you wouldn't even be tested, you might actually save yourself a visit,” said Dr. Andrew Fine, an emergency physician at Boston Children's Hospital.
The trick: Combine some of the symptoms that doctors look for with a bit of computer data to tell if strep throat is circulating in your geographical region. If the bug's in your neighborhood, that increases the chances that you've caught it, said Dr. Kenneth Mandl, a Harvard University professor and informatics specialist with Boston Children's.
Fine and Mandl turned to the records of more than 70,000 sore throat patients who got strep tests and had their symptoms recorded at clinics in six states between 2006 and 2008. They determined those people's risk of strep using the experimental scorecard approach and checked the computer model's accuracy against the strep test results.
Nationally, identifying those with less than a 10 percent chance of strep throat could save 230,000 doctor visits a year, the team reported Monday in the journal Annals of Internal Medicine.
The method wasn't perfect: It meant 8,500 strep cases would have been missed, or the diagnosis delayed, concluded the government-funded study.
But Mandl said it's unlikely that would lead to lasting harm, as most of the infections would clear up on their own, or persisting pain eventually would send a person to the doctor.
Much more research is needed to prove whether the method would work in everyday life and whether a mobile app or a phone call to the doctor would be the best approach.
Because strep is most common in children ages 5 to 15, doctors usually test youngsters with a sore throat for the bacteria.
For anyone 15 or older, Mandl said doctors may skip a test depending on symptoms. While a cough and runny nose are more typical of a cold virus, strep symptoms might include a fever, enlarged lymph nodes, tonsils with swelling or pus and the lack of a cough.
Fine and Mandl focused first on those over age 15. Because feeling lymph nodes and peeking at tonsils could be difficult for the average layman, their scorecard posed easy questions: Is there a fever? Is there a cough? Then came the key: The scorecard automatically merged those symptoms with local trends in strep diagnosis.
In an accompanying editorial, Dr. Robert Centor of the University of Alabama, Birmingham, said too many clinics and emergency rooms still test all sore throats for strep.
But he questioned whether the home scorecard approach would make a difference, wondering if biosurveillance would be too costly or if average patients even would use it before seeking care.
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