Rational decisions in managing sore throat: evaluation of a rapid test
Br Med J (Clin Res Ed) 1988; 296 doi: https://doi.org/10.1136/bmj.296.6637.1646 (Published 11 June 1988) Cite this as: Br Med J (Clin Res Ed) 1988;296:1646
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- Peter Burke,
- John Bain,
- Andrew Lowes,
- Roger Athersuch
Abstract
Sixty nine general practitioners recorded what they had prescribed for a total of 1189 episodes of sore throat. Antibiotics were prescribed in 763 (64%) episodes and broad spectrum antibiotics in 161 (21%) of these. If there was dysphagia, hoarseness, cervical adenopathy, and inflamed or purulent tonsils a prescription was more likely to be written. An enzyme immunoassay rapid test was evaluated as a means of rationalising prescribing. Among 23 general practitioners and 250 patients the sensitivity of the test was 63% and the specificity 91·7% compared with 74% and 58% for clinical assessment alone. Test results rarely caused previous prescribing decisions (155 (13%) episodes) to be altered.
We suggest that the time is not ripe for the use of the enzyme immunoassay rapid test on a wide scale in the routine assessment of sore throats.