The Liverpool Peritonsillar abscess Score: Development of a predictive score through a prospective multicentre...

Area of Science:

• Otolaryngology
• Emergency Medicine
• Diagnostic score development

Background:

• Peritonsillar abscess (PTA) is a common reason for Ear, Nose, and Throat (ENT) referrals.
• Diagnostic uncertainty among non-specialists can lead to delays and concerns.
• There is a need for a reliable tool to aid in the diagnosis of PTA.

Purpose of the Study:

• To develop and validate a predictive score for peritonsillar abscess (PTA).
• To improve diagnostic certainty for non-specialist clinicians managing sore throat patients.
• To support ENT surgeons in triaging referrals effectively.

Main Methods:

• A prospective, multicentre observational study involving primary and secondary care.
• Data collection on demographics, symptoms, and clinical signs in patients over 16 with sore throat.
• Binary logistic regression analysis and iterative development and internal validation of a predictive score.

Main Results:

• The Liverpool Peritonsillar abscess Score (LPS) was developed using five significant variables: unilateral sore throat, trismus, male gender, pharyngeal voice change, and uvular deviation.
• Internal validation demonstrated high performance: sensitivity 96%, specificity 85%, PPV 85%, NPV 96%, and AUROC 0.970.
• The LPS is the first predictive score for PTA based on non-specialist accessible signs and symptoms.

Conclusions:

• The developed Liverpool Peritonsillar abscess Score (LPS) is a valuable tool for diagnosing PTA.
• The score's high negative predictive value is particularly beneficial for non-specialist clinicians.
• The LPS can enhance diagnostic accuracy and streamline referral triage for suspected PTA.