Cohen 1998.

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: physician Exclusion if recent antibiotics use before inclusion: yes (within 7 days before inclusion) Clinical selection of patients: implicit criteria (see below) Presenting signs and symptoms: acute pharyngitis or tonsillitis with dysphagia or fever Age range for inclusion: 4 to 15 years
Patient characteristics and setting	Sample size: 563 Age (distribution): not reported GAS prevalence according to culture (with 95% confidence interval): 21.5% (95% CI not reported) Country of study: France Sex (% of girls): not reported Clinical severity assessment: none Clinical setting: office‐based Multi‐centre study
Index tests	Throat swab: 2 different (first one for the RADT, second one only if RADT+) Commercial name of the RADT: TestPack Plus Strep A (Abbott) Type of RADT: EIA
Target condition and reference standard(s)	Throat culture medium: inhibitory 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 (in French)
Notes	The study was supported by ASTRA laboratories
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)?	Yes
Was clinical selection of patients avoided?	No
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?	Yes
		Low	Low
DOMAIN 3: Reference Standard
Were culture results interpreted with blinding of the results of the RADT?	No
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
		High	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?	No
Did patients receive the same throat culture method?	Yes
Were undetermined/uninterpretable results reported?	Yes
Were withdrawals from the study explained?	Yes
		High