SynthesisThe British journal of general practice : the journal of the Royal College of General Practitioners2020
Comparison of Centor and McIsaac scores in primary care: a meta-analysis over multiple thresholds.
Synthesis in The British journal of general practice : the journal of the Royal College of General Practitioners, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 25 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it.
- On estimating a constrained bivariate random effects model for meta-analysis of test accuracy studies.Statistical methods in medical research · 2022Pooled it
- Multi-center investigation on the influence of clinical characteristics and molecular group A streptococci diagnostics on the management of tonsillopharyngitis in pediatric practices in Berlin-BASE study.European journal of pediatrics · 2026Trial
- Amoxicillin vs. placebo to reduce symptoms in children with group A streptococcal pharyngitis: a randomized, multicenter, double-blind, non-inferiority trial.European journal of pediatrics · 2024Trial
- Towards AI-Based Strep Throat Detection and Interpretation for Remote Australian Indigenous Communities.Sensors (Basel, Switzerland) · 2025Article
- Adherence to NICE Guidelines and Centor Criteria in Acute Sore Throat Management: An Audit Cycle.Cureus · 2025Article
- General Practitioner's Practice in Romanian Children with Streptococcal Pharyngitis.Medicina (Kaunas, Lithuania) · 2025Article
- Article
- Global spread of Streptococcus pyogenes A genomics-supported narrative review.FEMS microbiology reviews · 2025Review
- [Clinical diagnosis of group AZhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2024Review
- Symptoms predictive of Fusobacterium necrophorum pharyngotonsillitis - an observational study of cases presenting to hospitals in Southern Sweden.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2024Observational
- Does the Addition of Point-of-Care Testing Alter Antibiotic Prescribing Decisions When Patients Present with Acute Sore Throat to Primary Care? A Prospective Test of Change.Diagnostics (Basel, Switzerland) · 2024Article
- Treatment of Acute Sore Throat in Malaysia: A Consensus of Multidisciplinary Recommendations Using Modified Delphi Methodology.Infection and drug resistance · 2024Review
- Acute pharyngitis in children and adults: descriptive comparison of current recommendations from national and international guidelines and future perspectives.European journal of pediatrics · 2023Review
- Article
- Antibiotic Use for Common Infections in Pediatric Emergency Departments: A Narrative Review.Antibiotics (Basel, Switzerland) · 2023Review
- Identifying Group A Streptococcal Pharyngitis in Children Through Clinical Variables Using Machine Learning.Cureus · 2023Article
- Diagnosis and management of acute pharyngotonsillitis among pediatric patients at Ribat Teaching Hospital: a prospective audit (2021-2022).Sudanese journal of paediatrics · 2023Article
- Characteristics of the sore throat test and treat service in community pharmacies (STREP) in Wales: cross-sectional analysis of 11 304 consultations using anonymized electronic pharmacy records.The Journal of antimicrobial chemotherapy · 2022Article
- Overuse of medical care in paediatrics: A survey from five countries in the European Academy of Pediatrics.Frontiers in pediatrics · 2022Article
- Use of the McIsaac Score to Predict Group A Streptococcal Pharyngitis in Outpatient Nurse Phone Triage and Electronic Visits Compared With In-Person Visits: Retrospective Observational Study.Journal of medical Internet research · 2021Observational
Corrections and comments
- Commented on by
- Commented on by
- Erratum issuedCorrection.2020
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCentor and McIsaac scores are both used to diagnose group A beta-haemolytic streptococcus (GABHS) infection, but have not been compared through meta-analysis.
aimTo compare the performance of Centor and McIsaac scores at diagnosing patients with GABHS presenting to primary care with pharyngitis. DESIGN AND
settingA meta-analysis of diagnostic test accuracy studies conducted in primary care was performed using a novel model that incorporates data at multiple thresholds.
methodMEDLINE, EMBASE, and PsycINFO were searched for studies published between January 1980 and February 2019. Included studies were: cross-sectional; recruited patients with sore throats from primary care; used the Centor or McIsaac score; had GABHS infection as the target diagnosis; used throat swab culture as the reference standard; and reported 2 × 2 tables across multiple thresholds. Selection and data extraction were conducted by two independent reviewers. QUADAS-2 was used to assess study quality. Summary receiver operating characteristic (SROC) curves were synthesised. Calibration curves were used to assess the transferability of results into practice.
resultsTen studies using the Centor score and eight using the McIsaac score were included. The prevalence of GABHS ranged between 4% and 44%. The areas under the SROC curves for McIsaac and Centor scores were 0.7052 and 0.6888, respectively. The
conclusionBoth Centor and McIsaac scores provide only fair discrimination of those with and without GABHS, and appear broadly equivalent in performance. The poor calibration for a positive test result suggests other point-of-care tests are required to rule in GABHS; however, with both Centor and McIsaac scores, a score of ≤0 may be sufficient to rule out infection.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.