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Peer reviewedOpen accessGroup A streptococcal pharyngitis

2025 Clinical Practice Guideline Update by the Infectious Diseases Society of America on Group A Streptococcal Pharyngitis: Risk Assessment Using Clinical Scoring Systems in Children and Adults

Clinical Infectious Diseases·

Jeffrey A Linder, Michael E Watson, Michael R Wessels, Danielle M Carter, Adam L Cohen, Jennifer Dien Bard, Guliz Erdem, Christopher J Gregory, Athena P Kourtis, Judith M Martin, A Brian Mochon, Daniel J Shapiro, Ryan W Stevens, Dipleen Kaur, Miriam B Barshak

DOI
10.1093/cid/ciaf668
PMID
41343363
PMCID
OpenAlex
Study type
Systematic review
Publisher
Oxford University Press (OUP)
Article type
journal-article
Integrity
current

Why this research matters now

A scoring-based approach may help reduce unselective testing for GAS pharyngitis, potentially lowering cost and inconvenience for low-risk individuals.

01

Structured evidence summary

Research question

The paper asks whether clinical scoring systems should be used to guide decisions about diagnostic testing for group A streptococcal pharyngitis, compared with clinician judgement alone.

Study design

A systematic review of randomized and non-randomized studies comparing clinical scoring systems to clinician judgement for predicting throat culture outcomes, conducted as part of an IDSA clinical practice guideline update.

Population and setting

Children and adults presenting with sore throat, evaluated in studies informing IDSA guideline recommendations.

Main findings

Evidence from the reviewed studies suggests that diagnostic accuracy of clinical scoring systems is comparable to or slightly higher than clinician judgement alone. The panel judged that benefits and harms favor using a scoring system, primarily to identify low-probability patients and reduce unnecessary testing.

Public-health relevance

A scoring-based approach may help reduce unselective testing for GAS pharyngitis, potentially lowering cost and inconvenience for low-risk individuals.

Important limitations

The underlying studies are limited by small size, lack of uniformity in outcome measures, and incomplete data. No additional limitations are explicitly stated in the supplied abstract or metadata.

GIDS interpretation

The paper is indexed for Group A streptococcal pharyngitis and the topics of diagnostics and health policy; this summary is limited to the supplied single-article abstract/metadata and does not connect the work to any live surveillance signal.

02

Related GIDS surveillance

Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.

03

Evidence relationships

This article has 8 auditable classifier relationships to diseases, places, topics, and study design.

about diseaseaddresses topicaddresses topicevaluates interventioninforms policy domainstudied population settingstudies populationuses study design