Share this article on:

Accuracy and Interobserver Variation of Three Clinical Decision Rules for the Diagnosis of Streptococcal Pharyngitis

Orofino, Dulce Helena Gonçalves MSc*†; Passos, Sônia Regina Lambert PhD*; de Andrade, Carlos Augusto Ferreira PhD*; Nigri, Daniel MD; dos Santos Werneck, Lúcia BS; de Oliveira, Raquel Carvalhaes PhD*; Hökerberg, Yara Hahr Marques PhD*

The Pediatric Infectious Disease Journal: June 2013 - Volume 32 - Issue 6 - p 686–687
doi: 10.1097/INF.0b013e3182868b32
Brief Reports

We evaluated the accuracy and interobserver variation of 3 clinical decision rules for streptoccocal pharyngitis diagnosis. Oropharyngeal swab culture was the reference. The Abu Reesh rule had the highest sensitivity and the World Health Organization rule showed the highest specificity. The interobserver variation of those rules indicates the need for better training of clinicians.

Supplemental Digital Content is available in the text.

From the *Laboratory of Clinical Epidemiology of the Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz; Souza Marques Medical School; and Prontobaby Hospital, Rio de Janeiro, Brazil.

This study was funded by the Technological Research and Development Program (PIPDT-2011) of the IPEC/FIOCRUZ and the Carlos Chagas Foundation of Research Support—FAPERJ (S.R.L.P. had a fellowship JCNE E-26/101–511/2010, and D.N. had a PIBIC CNPq scholarship.). The funding sources had no role in the following: study design and conduct; and data collection, analysis and interpretation. D.H.G.O. had full access to all data and final responsibility for the decision to submit for publication on behalf of all authors. The authors have no other funding or conflicts of interest to disclose.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (

Address for correspondence: Dulce Helena Gonçalves Orofino, MSc, Laboratory of Clinical Epidemiology of the Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, Avenida Brasil 4036 sala 301-A-Manguinhos, Rio de Janeiro, Brazil. E-mail:

© 2013 Lippincott Williams & Wilkins, Inc.