Table 5. Performance of clinical decision rules for streptococcal pharyngitis in children from Cape Town.
| Clinical Decision Rule | Sens | Spec | PPV | NPV | LR+ | MDx (%) | WDx (%) | MDx/WDx |
|---|---|---|---|---|---|---|---|---|
| Abu Reesh | 75.2 | 39.4 | 24.8 | 85.7 | 1.24 | 51 (25) | 470 (61) | 0.11 |
| Wald | 99 | 3.1 | 21.3 | 92.1 | 1.21 | 2 (1) | 752 (97) | 0.002 |
| Steinhoff | 79.8 | 34.1 | 24.4 | 86.4 | 1.21 | 42 (20) | 511 (66) | 0.08 |
| McIsaac | 51.4 | 64.7 | 27.9 | 83.4 | 1.46 | 100 (49) | 274 (35) | 0.37 |
| WHO | 36.5 | 73.8 | 27.0 | 81.4 | 1.39 | 131 (64) | 203 (26) | 0.64 |
| Attia | 76.2 | 36.3 | 24.1 | 85.2 | 1.20 | 49 (24) | 494 (64) | 0.10 |
| Cape Towna | 83.7 | 32.2 | 24.8 | 88.1 | 1.24 | 33 (16) | 525 (68) | 0.06 |
Sens, sensitivity; Spec, specificity; PPV, positive predictor value; NPV, negative predictive value all expressed as percentages; LR+, positive likelihood ratio; MDx (%), number of missed diagnoses of streptococcal pharyngitis and percentage of all true strep cases (=1-sensitivity); WDx (%), number of wrong diagnoses (unnecessarily treated non-cases) and percentage of all non-strep cases (=1-specificity).
a
Evaluated at the suggested score of 3/5 incorporating tonsillar swelling as compulsory symptom