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Modified Centor score (McIsaac)

Estimates group A β-hemolytic streptococcal pharyngotonsillitis probability in children from age 3 and adults, guiding who to test.

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Check the population, units and version. The result shows the formula or classification; it does not make an automatic treatment decision.

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Method · Limits of application

McIsaac 1998 / Fine 2012: four findings worth 1 point each and an age adjustment; preliminary sum −1 to 5, final score bounded from 0 to 4

McIsaac’s 1998 study assessed people aged 3–76 years with new respiratory symptoms in family medicine, comparing the score with throat culture. The total does not establish certainty of streptococcal infection or an automatic indication for antibiotics. Age weights, cutoffs and testing strategy must follow the table and guideline for the version used. The original 1998 edition and the method described by Fine in 2012 define the final score from 0 to 4. The preliminary sum from −1 to 5 is separate calculation information and must not be treated as the final score of these editions. The review covers only the weights and this normalization; it does not approve ascertainment of the signs, diagnostic performance, probabilities, testing or treatment.

Conditions of use

Check the population, units, inclusion and exclusion criteria, and version in the original source. A result alone does not establish a diagnosis, discharge decision or prescription.

Documented parameters

Temperature > 38 °C
Absence of cough
Enlarged, tender anterior cervical lymph nodes
Tonsillar swelling or exudate
Age

4/4 reference cases checked. Numerical tests are not clinical validation.

Sources and documentation

Documented formula

Transcribed from the source or a recorded revision; this is not a clinical recommendation.

Preliminary sum: 1 point for each of the four findings — fever > 38 °C, absence of cough, tender anterior cervical lymphadenopathy, and tonsillar swelling or exudate —, plus 1 point at ages 3 to 14 years, 0 at ages 15 to 44 years, and −1 at age 45 years or older. The preliminary sum ranges from −1 to 5. Final score: preliminary results below 0 are set to 0 and those above 4 are set to 4, as described by McIsaac 1998 and Fine 2012. The preliminary sum is recorded separately; probabilities and management decisions have not received clinical approval.

References

Identifier: centor-mcisaac

Original clinical content: Brazilian Portuguese.

Method version

McIsaac 1998 / Fine 2012: four findings worth 1 point each and an age adjustment; preliminary sum −1 to 5, final score bounded from 0 to 4

centor-mcisaac@native-2026-10-04+5ebdcddfc2bb

Source for the active edition

The bibliographic edition identifies the source. By itself, it proves neither full conformity of the formula nor clinical approval.

Synthetic cases checked (4)

Synthetic cases for checking the implementation, with no patient data.

Case 1

reference-001

Inputs

Temperature > 38 °C: Yes
Age: ≥ 45 years
Absence of cough: No
Enlarged, tender anterior cervical lymph nodes: No
Tonsillar swelling or exudate: No

{
  "febre": true,
  "idade": "-1",
  "tosse": false,
  "linfo": false,
  "amig": false
}

Expected result

{
  "score": 0,
  "level": "low",
  "verdict": "1 a 2,5%"
}

Actual result

{
  "score": 0,
  "preliminaryScore": 0
}

Case 2

reference-002

Inputs

Temperature > 38 °C: Yes
Absence of cough: Yes
Age: 15 to 44 years
Enlarged, tender anterior cervical lymph nodes: No
Tonsillar swelling or exudate: No

{
  "febre": true,
  "tosse": true,
  "idade": "0",
  "linfo": false,
  "amig": false
}

Expected result

{
  "score": 2,
  "level": "mid",
  "verdict": "11 a 17%"
}

Actual result

{
  "score": 2,
  "preliminaryScore": 2
}

Case 3

reference-003

Inputs

Temperature > 38 °C: Yes
Absence of cough: Yes
Enlarged, tender anterior cervical lymph nodes: Yes
Tonsillar swelling or exudate: Yes
Age: 3 to 14 years

{
  "febre": true,
  "tosse": true,
  "linfo": true,
  "amig": true,
  "idade": "1"
}

Expected result

{
  "score": 4,
  "level": "high",
  "verdict": "51 a 53%"
}

Actual result

{
  "score": 4,
  "preliminaryScore": 5
}

Case 4

reference-004

Inputs

Temperature > 38 °C: Yes
Absence of cough: Yes
Enlarged, tender anterior cervical lymph nodes: Yes
Tonsillar swelling or exudate: Yes
Age: ≥ 45 years

{
  "febre": true,
  "tosse": true,
  "linfo": true,
  "amig": true,
  "idade": "-1"
}

Expected result

{
  "score": 3,
  "level": "mid",
  "verdict": "28 a 35%"
}

Actual result

{
  "score": 3,
  "preliminaryScore": 3
}

Code and reproducibility

This tool’s code on GitHub

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Sources, version and reproduction instructions

The code tests are technical checks. Clinical approval and professional translation review are recorded separately.

Relationship with cancer research

General context — relationship to be defined

A resource for general clinical contexts. This edition does not assign a specific oncological relationship; selecting it for a study requires a justified question, population and purpose.