The Modified Centor Score, also known as the McIsaac Score, is a clinical decision tool used in the assessment of patients presenting with sore throat. It is specifically designed to predict the likelihood of Group A Streptococcus (GAS) pharyngitis, a common cause of throat infection.
The score is applicable to both pediatric and adult populations, but it is particularly useful in primary care settings where rapid strep testing may not be readily available. The Modified Centor Score helps clinicians decide whether to treat a sore throat with antibiotics or not, based on the probability of a streptococcal infection.
The score takes into account five factors: patient's age, presence of fever, absence of cough, swollen and tender cervical lymph nodes, and tonsillar swelling or exudate. Each factor contributes to the total score, which ranges from -1 to 5.
There are no specific exclusion criteria for the use of the Modified Centor Score, but it should be noted that it is not designed to predict other causes of pharyngitis, and should not replace clinical judgment. It is also less accurate in populations where the prevalence of GAS pharyngitis is very low or very high.
Reference
Warren J McIsaac, James D Kellner, Peggy Aufricht et al. Empirical validation of guidelines for the management of pharyngitis in children and adults. JAMA. 2004 Apr 7;291(13):1587-95.
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