Table 1.

Probability Assumptions and Costs

AssumptionsCosts
Probability of GABHS.29Visit$    27
High-sensitivity antigen testOral penicillin$     2
 Sensitivity.891High-sensitivity antigen test$     7
 Specificity.950Culture$     5
CultureFollow-up$     5
 Sensitivity.834Mild allergic reaction$    35
 Specificity.990Day of illness$     0
Treatment ratesSevere allergic reaction$  4194*
 After positive antigen test1.00Suppurative complication$  4564*
 After positive throat culture.90Acute rheumatic fever$20 000
Treatment efficacy.90
Complication rates (after untreated infection)
 Acute rheumatic fever.0003
 Peritonsillar abscess.01
Allergic reactions (after oral penicillin)
 Mild.00525
 Severe.00025
  • * Based on charges at Baystate Medical Center, Springfield, MA.

  • Based on Tompkins et al24 (1977) and North et al30 (1993), adjusted at 3.5% inflation.