Clinical findings in patients presenting with sore throat. A study on inter-observer reliability.

BACKGROUND

Several clinical prediction scores have been developed to help practitioners assess the probability of streptococcal throat infection. Prior to this study, it was not known how reliably doctors assess the signs that contribute to these decision aids.

OBJECTIVE

The aim of this study was to measure the inter-observer reliability of clinical findings related to sore throat.

METHODS

Consecutive patients presenting with sore throat in five primary care practices in Germany took part (n = 126). Each patient was assessed independently by two doctors with regard to lymph nodes, pharynx, soft palate and tonsils.

RESULTS

Agreement among practitioners was not satisfactory.

CONCLUSIONS

Results suggest that the performance of clinical scoring systems can be improved by training on how to elicit relevant clinical signs. Our findings cast some doubt on the effectiveness of under- and post-graduate training in this area.