背景：喉咙痛是一个常见问题，也是抗生素过度使用的常见原因。一种基于网络的工具，可以帮助人们评估喉咙痛，通过使用临床预测规则，取喉咙拭子或唾液样本，拍喉咙照片，有可能改善自我管理，并帮助识别最可能和最不可能从抗生素中受益的人。
目的：我们旨在开发一种基于网络的工具，以帮助患者和父母或照顾者自我评估咽喉痛症状并拍摄咽喉照片。拭子,和用于诊断测试的唾液样本。然后，我们探讨了在患有喉咙痛的成人和儿童中使用该工具的可接受性和可行性。
方法：我们使用基于人的方法开发了一种基于网络的工具，然后通过参加一般实践或通过社交媒体广告招募参加这项研究的患有喉咙痛的成年人和儿童。参与者自我评估FeverPAIN和Centor评分标准的存在，并试图拍摄他们的喉咙，并进行喉咙拭子和唾液测试。通过视频通话观察研究过程，并采访了参与者对使用基于网络的工具的看法。将自我评估的咽喉炎症和脓液与临床医生对患者咽喉照片的评估进行比较。
结果：共招募了45名参与者（33名成人和12名儿童）。其中,35（78％）和32（71％）参与者完成了FeverPAIN和Centor得分的所有得分要素，分别,大多数人（30/45，67%）报告发现自我评估相对容易。淋巴结肿大没有有效反应，喉咙发炎，和喉咙上的脓液11（24％），9（20%），和13名(29%)参与者。共有18名（40％）参与者提供了足够质量的喉咙照片，用于临床评估。与临床医生评估的照片相比，患者对炎症的评估的敏感性为100％（3/3），特异性为47％（7/15）。喉咙上的脓液，敏感性为100%(3/3),特异性为71%(10/14).总共89%（40/45），93%（42/45），89%（40/45），80%(30/45)的参与者提供了可分析的细菌拭子，病毒拭子,唾液海绵,和唾液流口水样本，分别。参与者通常对提供样品感到满意和自信，唾液样本被评为比拭子样本稍微更可接受。
结论：大多数成人和父母参与者能够使用基于网络的干预措施来评估咽喉感染的临床特征，并使用临床预测规则生成评分。然而,有些人难以评估临床症状，如淋巴结，喉咙脓液,和炎症，评分被评估为敏感但非特异性.许多参与者在拍摄足够质量的照片时遇到问题，但大多数人都能采集咽拭子和唾液样本。
Sore throat is a common problem and a common reason for the overuse of antibiotics. A web-based tool that helps people assess their sore throat, through the use of clinical prediction rules, taking throat swabs or saliva samples, and taking throat photographs, has the potential to improve self-management and help identify those who are the most and least likely to benefit from antibiotics.
We aimed to develop a web-based tool to help patients and parents or carers self-assess sore throat symptoms and take throat photographs, swabs, and saliva samples for diagnostic testing. We then explored the acceptability and feasibility of using the tool in adults and children with sore throats.
We used the Person-Based Approach to develop a web-based tool and then recruited adults and children with sore throats who participated in this
study by attending general practices or through social media advertising. Participants self-assessed the presence of FeverPAIN and Centor score criteria and attempted to photograph their throat and take throat swabs and saliva tests.
Study processes were observed via video call, and participants were interviewed about their views on using the web-based tool. Self-assessed throat inflammation and pus were compared to clinician evaluation of patients\' throat photographs.
A total of 45 participants (33 adults and 12 children) were recruited. Of these, 35 (78%) and 32 (71%) participants completed all scoring elements for FeverPAIN and Centor scores, respectively, and most (30/45, 67%) of them reported finding self-assessment relatively easy. No valid response was provided for swollen lymph nodes, throat inflammation, and pus on the throat by 11 (24%), 9 (20%), and 13 (29%) participants respectively. A total of 18 (40%) participants provided a throat photograph of adequate quality for clinical assessment. Patient assessment of inflammation had a sensitivity of 100% (3/3) and specificity of 47% (7/15) compared with the clinician-assessed photographs. For pus on the throat, the sensitivity was 100% (3/3) and the specificity was 71% (10/14). A total of 89% (40/45), 93% (42/45), 89% (40/45), and 80% (30/45) of participants provided analyzable bacterial swabs, viral swabs, saliva sponges, and saliva drool samples, respectively. Participants were generally happy and confident in providing samples, with saliva samples rated as slightly more acceptable than swab samples.
Most adult and parent participants were able to use a web-based intervention to assess the clinical features of throat infections and generate scores using clinical prediction rules. However, some had difficulties assessing clinical signs, such as lymph nodes, throat pus, and inflammation, and scores were assessed as sensitive but not specific. Many participants had problems taking photographs of adequate quality, but most were able to take throat swabs and saliva samples.
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