Chapin 2002.

Study characteristics
Patient sampling	Cross‐sectional study Prospective design Sample: consecutive Direct comparison of different RADTs: no (comparison of a RADT with a DNA probe test) Direct comparison of several throat culture techniques: no Person performing the throat sample: physicians Exclusion if recent antibiotics use before inclusion: no Clinical selection of patients: none Presenting signs and symptoms: symptoms of pharyngitis Age range for inclusion: not reported ("paediatric outpatient clinics")
Patient characteristics and setting	Sample size: 520 Age (distribution): not reported GAS prevalence according to culture (with 95% confidence interval): 33.1% (95% CI not reported) Country of study: USA Sex (% of girls): not reported Clinical severity assessment: none Clinical setting: walk‐in clinic ("paediatric outpatient clinics") Multi‐centre study
Index tests	Throat swab: 1 double swab (1 swab was used for the RADT, 1 swab for the DNA probe technique, and the pledget was used for culture) Commercial name of the RADT: Strep A OIA (Thermo Biostar) Type of RADT: OIA
Target condition and reference standard(s)	Throat culture medium: enrichment Atmosphere of incubation: anaerobic Duration of incubation: 48 hours GAS confirmation: latex test Number of plates inoculated: 1 Assessment of GAS antibody response: no Relevant details: ‐
Flow and timing	No follow‐up
Comparative
Type of study	Journal article
Notes	The RADT was compared to a DNA probe technique; such molecular tests are not in the scope of this review. Travel grant support provided by Gen‐Probe, manufacturer of the DNA probe assay under evaluation
Methodological quality
Item	Authors' judgement	Risk of bias	Applicability concerns
DOMAIN 1: Patient Selection
Was a consecutive or random sample of patients enrolled?	Yes
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?	Yes
Were patients seen in an ambulatory care setting?	Yes
		High	Low
DOMAIN 2: Index Test All tests
Were the RADT results interpreted with blinding of the results of culture?	Yes
Was the type of the RADT mentioned (EIA or OIA)?	Yes
Were RADTs conducted during consultation time?	No
		Low	High
DOMAIN 3: Reference Standard
Were culture results interpreted with blinding of the results of the RADT?	Yes
Is the throat culture method likely to correctly identify GAS (laboratory culture on a blood agar plate during 48 hr)?	Yes
Were the culture medium, atmosphere, duration of incubation and GAS‐confirmation technique described?	Yes
		Low	Low
DOMAIN 4: Flow and Timing
Was the delay between the performance of the RADT and throat culture plating less than 48 hours?	Yes
Did all patients receive a throat culture?	Yes
Did patients receive the same throat culture method?	Yes
Were undetermined/uninterpretable results reported?	No
Were withdrawals from the study explained?	Yes
		Low