Management criteria, recording of performance, and peer review of tonsillopharyngitis

As part of a national study to formulate criteria for chart audit of quality assurance of child health care, criteria were developed for diagnosis and management of tonsillopharyngitis. These criteria were validated by pediatricians and family physicians in academic medicine and in practice. They were judged relevant to the medical care process and patient outcome by both. The selected criteria were also recommended by the majority of two large physician groups for use in peer review. In the first three phases of the study most of these criteria were said to be performed and recorded by a majority of physicians. However, in the fourth (community) phase, when charts of 166 primary-care physicians were actually audited, documentation was so poor that peer review by chart audit would be impractical at present.