Predicting Mortality in Community Acquired Pneumonia – Dr. Robert Centor Interviews PSI Creator Dr. Michael Fine

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Centor’s Corner

Dr. Michael Fine, professor of medicine at the University of Pittsburgh, led the team that developed the Pneumonia Severity Index (PSI) and began studying the prognosis and other clinical aspects of community-acquired pneumonia (CAP) in the early 1990s.

His interest in predicting mortality in CAP started while he served as chief resident in internal medicine at the University of Pittsburgh. His mentor, Dr. Wishwa Kapoor, then hired him after his general internal medicine fellowship in the Harvard Generalist Faculty Development Program.  At the time Dr. Fine transitioned from fellowship to faculty at the University of Pittsburgh, the Agency for Health Care Policy and Research (now the Agency for Healthcare Research and Quality, AHRQ) had a well-funded portfolio of research projects called PORT (Patient Outcome Research Teams) studies.   Continue reading “Predicting Mortality in Community Acquired Pneumonia – Dr. Robert Centor Interviews PSI Creator Dr. Michael Fine”

Centor’s Corner: The Story of FENa

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Centor’s Corner

September, 1976: I was a 2nd year internal medicine resident at the Medical College of Virginia.

My attending physician, Dr. Carlos Espinel, had just published a now-classic article: The FENa test.

So that month, I had the wonderful opportunity to understand the rationale behind a test that I now have used for over 40 years.

Continue reading “Centor’s Corner: The Story of FENa”

Centor’s Corner: FeverPAIN versus Centor Score

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Centor’s Corner

Editor’s note: Centor’s Corner is a new Paging MDCalc column featuring our favorite pharyngitis guru, blogger extraordinaire, and Scientific Advisory Board member Dr. Robert Centor, with regular insights from Dr. Centor on the applications of evidence to practice and musings from an experienced clinician. To comment on Centor’s Corner articles, please e-mail the editor at rachel@mdcalc.com or tweet directly to Dr. Centor @medrants.

On Twitter recently, several British tweeters discussed whether they should use the FeverPAIN Score or the Centor Score.  Obviously I have a bias here, but I will try to discuss this issue dispassionately.

Continue reading “Centor’s Corner: FeverPAIN versus Centor Score”

Insights from Dr. Robert M. Centor, Creator of the Centor Score for Strep Pharyngitis

Antibiotic overuse and misuse is a growing public health concern, and foregoing the administration of antibiotics in cases where they are not needed can be a challenging decision to defend without good evidence to back it up. The Centor Score for Strep Pharyngitis is one of the most practical and useful evidence-based decision tools that helps support clinicians in making those decisions. We interviewed Dr. Robert Centor on developing and using the Centor Score.

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Why did you develop the Centor Score? Was there a clinical experience that inspired you to create a this tool for clinicians?
In 1979, while working in the “non-acute” adult emergency room, a resident asked me how to evaluate a sore throat patient. Having just finished my residency, I started to give a definitive answer, but had a moment of humility and told him that I did not know. We made a treatment decision at the time, and I went to the library to learn more. Continue reading “Insights from Dr. Robert M. Centor, Creator of the Centor Score for Strep Pharyngitis”

Sometimes it’s NOT just a sore throat – adolescents and young adults are different

Written by Dr. Robert Centor, creator of the Centor Score. Twitter: @medrants

In medical school we spend little time learning Pharyngalgiaabout sore throats. After all, it’s just a sore throat.

Group A beta-hemolytic streptococcal (GAS) tonsillitis dominates our sore throat concern, because it can cause acute rheumatic fever and peritonsillar abscess. We have rapid antigen tests for GAS so that we can treat patients with that infection. Continue reading “Sometimes it’s NOT just a sore throat – adolescents and young adults are different”