For anyone 15 or older, Mandl said doctors may skip a test depending on symptoms. While a cough and runny nose are more typical of a cold virus, strep symptoms might include a fever, enlarged lymph nodes, tonsils with swelling or pus and lack of a cough.
So Fine and Mandl focused first on the over-15 crowd. Because feeling lymph nodes and peeking at tonsils could be difficult for the average layman, their scorecard posed easy questions: Is there a fever? Is there a cough?
Then came the key: The scorecard automatically merged those symptoms with local trends in strep diagnosis.
It’s a practice called biosurveillance. Already, hundreds of hospitals, clinics and health departments automatically report certain symptoms and diagnoses to the government. That lets officials track the spread of flu every year, for example — and some web sites now show flu activity by zip code so people can check if influenza has reached their community.
Likewise, results of strep tests are available digitally from testing laboratories, clinics, even large doctors’ offices, Mandl said. They just have to be collected and used, which isn’t routine.
In an accompanying editorial, Dr. Robert Centor of the University of Alabama, Birmingham, said too many clinics and emergency rooms still give a strep test to every sore throat patient.
But he questioned if the home scorecard approach would make a difference, wondering if biosurveillance would be too costly or if average patients even would use it before seeking care.
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