Andrew M. Fine

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BACKGROUND The Centor and McIsaac scores guide testing and treatment for group A streptococcal (GAS) pharyngitis in patients presenting with a sore throat, but they were derived on relatively small samples. We perform a national-scale validation of the prediction models on a large, geographically diverse population. METHODS We analyzed data collected from(More)
Central visual function is characteristically reported as Snellen acuity at distance and near. We performed functional tests in a group of patients with visual acuity of 20/100 or worse due to macular disease to determine whether there was a relationship between Snellen acuity and functional performance among these patients with poor visual acuity. Our(More)
OBJECTIVE Broadly, to create a bidirectional communication link between public health surveillance and clinical practice. Specifically, to measure the impact of integrating public health surveillance data into an existing clinical prediction rule. We incorporate data about recent local trends in meningitis epidemiology into a prediction model(More)
Objective To improve identification of pertussis cases by developing a decision model that incorporates recent, local, population-level disease incidence. Design Retrospective cohort analysis of 443 infants tested for pertussis (2003–7). Measurements Three models (based on clinical data only, local disease incidence only, and a combination of clinical data(More)
BACKGROUND Consensus guidelines recommend against testing or treating adults at low risk for group A streptococcal (GAS) pharyngitis. OBJECTIVE To help patients decide when to visit a clinician for the evaluation of sore throat. DESIGN Retrospective cohort study. SETTING A national chain of retail health clinics. PATIENTS 71 776 patients aged 15(More)
BACKGROUND Clinical prediction rules do not incorporate real-time incidence data to adjust estimates of disease risk in symptomatic patients. OBJECTIVE To measure the value of integrating local incidence data into a clinical decision rule for diagnosing group A streptococcal (GAS) pharyngitis in patients aged 15 years or older. DESIGN Retrospective(More)
STUDY OBJECTIVE We analyze the risks and benefits of alternative treatment strategies for non-septic-appearing febrile patients with influenza-like illnesses and possible exposure to anthrax. METHODS We used a decision analytic model to evaluate 6 testing and treatment strategies in an emergency department. Patients were non-septic-appearing and had(More)
reproduction in any medium, provided the original work is properly cited. Objective 1. To derive and validate an accurate clinical prediction model (" home score ") to estimate a patient's risk of group A streptococcal (GAS) pharyngitis before a health care visit based only on history and real-time local biosurveillance, and to compare its accuracy to(More)
OBJECTIVE To improve identification of pertussis cases by developing a decision model that incorporates recent, local, population-level disease incidence. DESIGN Retrospective cohort analysis of 443 infants tested for pertussis (2003-7). MEASUREMENTS Three models (based on clinical data only, local disease incidence only, and a combination of clinical(More)