Selective testing for streptococcal pharyngitis in adults

Some physicians test for group A streptococcal pharyngitis in all patients who have a sore throat, while others use a variety of clinical strategies to select patients to be tested. Using published data on the accuracy of a clinical decision rule, this benefit-cost analysis compares the calculated outcomes of 21 different management strategies applied to 1,000 hypothetical adults with pharyngitis. Strategies that best accomplish one physician's treatment goals may perform poorly when evaluated in a different practice setting or using different goals. The best strategies are identified for different treatment objectives and for different assumptions about the benefits of treatment so each physician can choose a strategy consistent with his or her preferences.