Al‐Najjar 2008.

Study characteristics
Patient sampling	Cross‐sectional study Prospective design Sample: unclear Direct comparison of different RADTs: no Direct comparison of several throat culture techniques: no Person performing the throat sample: unclear Exclusion if recent antibiotics use before inclusion: yes (exclusion if antibiotics during the preceding week) Clinical selection of patients: explicit criteria but not a score Presenting signs and symptoms: fever, acute catarrh and acutely inflamed throat/tonsils with or without exudates Age range for inclusion: not reported ("children")
Patient characteristics and setting	Sample size: 505 (but the contingency table includes 496 participants) Age (distribution): 81% under 5 years of age (mean or median not reported) GAS prevalence according to culture (with 95% confidence interval): 14.1% (95% CI not reported) Country of study: United Arab Emirates Sex (% of girls): 45% Clinical severity assessment: none Clinical setting: walk‐in clinics Multi‐centre study
Index tests	Throat swab: 1 double swab Commercial name of the RADT: Diaquick Strep A Test (Dialab) Type of RADT: EIA
Target condition and reference standard(s)	Throat culture medium: not reported Atmosphere of incubation: not reported Duration of incubation: not reported GAS confirmation: not reported Number of plates inoculated: not reported Assessment of GAS antibody response: no Relevant details: throat culture technique not described
Flow and timing	No follow‐up
Comparative
Type of study	Journal article
Notes	‐
Methodological quality
Item	Authors' judgement	Risk of bias	Applicability concerns
DOMAIN 1: Patient Selection
Was a consecutive or random sample of patients enrolled?	Unclear
Was it a cross‐sectional study or a RCT?	Yes
Were selection criteria clearly described (at least presenting signs and symptoms and age limits for inclusion)?	No
Was clinical selection of patients avoided?	No
Were patients seen in an ambulatory care setting?	Yes
		High	High
DOMAIN 2: Index Test All tests
Were the RADT results interpreted with blinding of the results of culture?	Unclear
Was the type of the RADT mentioned (EIA or OIA)?	Yes
Were RADTs conducted during consultation time?	Unclear
		Unclear	Unclear
DOMAIN 3: Reference Standard
Were culture results interpreted with blinding of the results of the RADT?	Unclear
Is the throat culture method likely to correctly identify GAS (laboratory culture on a blood agar plate during 48 hr)?	Unclear
Were the culture medium, atmosphere, duration of incubation and GAS‐confirmation technique described?	No
		Unclear	Unclear
DOMAIN 4: Flow and Timing
Was the delay between the performance of the RADT and throat culture plating less than 48 hours?	Unclear
Did all patients receive a throat culture?	Yes
Did patients receive the same throat culture method?	Unclear
Were undetermined/uninterpretable results reported?	No
Were withdrawals from the study explained?	No
		Unclear