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Roy M. Poses, MD
University of Medicine and Dentistry of New Jersey Rutgers Medical School Camden

Randall D. Cebul, MD
University of Pennsylvania Medical School Philadelphia

JAMA. 1986;255(6):746.

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In Reply.—

We agree with Dr Forsyth that single throat cultures cannot diagnose streptococcal pharyngitis as well as multiple cultures combined with antistreptolysin-O titers. However, in most clinical settings, single throat swabs are performed, and only their results are available in time to affect decision making. Our study was designed, not to assess the general accuracy of "clinical diagnosis," but specifically to assess the accuracy of physicians' probability estimates for a familiar test result used by them to make clinical decisions.

We believe that the methods used for obtaining cultures in our study were representative of those used in practice. The physicians swabbed the throat in the appropriate manner, and placed their swabs in a standard culturette (American Scientific Products) containing 0.5 mL of modified Stuart's bacterial transport medium. Cultures generally reached the laboratory in two hours. They were plated immediately and incubated aerobically. All isolates were serogrouped by the . . . [Full Text PDF of this Article]

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