Abstract
Adults at low risk for Group A streptococcal (GAS) pharyngitis should neither be tested nor treated, yet millions annually seek care. We derive and validate a ''home score'' to estimate a patient''s GAS risk based on history and real-time local biosurveillance, and compare its accuracy to traditional models. Data included 110,208 patients seen at a national retail health chain. Using a 0.10 home score cutoff extrapolates to 230,000 saved visits annually and 8500 additional missed cases (0.20: 2.9M visits saved, 320,000 additional missed). A patient-centric approach could save millions of visits annually by identifying low-risk patients in the pre-visit setting.