Clinical findings in patients presenting with sore throat - A study on inter-observer reliability

Background. Several clinical prediction scores have been developed to help practitioners assess the probability of streptococcal throat infection. Prior to this study, it was not known how reliably doctors assess the signs that contribute to these decision aids. Objective. The aim of this study was to measure the inter- observer reliability of clinical findings related to sore throat. Methods. Consecutive patients presenting with sore throat in five primary care practices in Germany took part ( n = 126). Each patient was assessed independently by two doctors with regard to lymph nodes, pharynx, soft palate and tonsils. Results. Agreement among practitioners was not satisfactory. Conclusions. Results suggest that the performance of clinical scoring systems can be improved by training on how to elicit relevant clinical signs. Our findings cast some doubt on the effectiveness of under- and post- graduate training in this area.