Gerber 1997.

Study characteristics
Patient sampling	Cross‐sectional study Prospective design Sample: consecutive Direct comparison of different RADTs: no Direct comparison of several throat culture techniques: yes Person performing the throat sample: unclear Exclusion if recent antibiotics use before inclusion: no Clinical selection of patients: none Presenting signs and symptoms: acute pharyngitis Age range for inclusion: not reported ("children")
Patient characteristics and setting	Sample size: 2113 Age (distribution): not reported GAS prevalence according to culture (with 95% confidence interval): 47.6% (95% CI not reported) Country of study: USA Sex (% of girls): not reported Clinical severity assessment: none Clinical setting: office‐based Multi‐centre study
Index tests	Throat swab: 1 single swab (used for culture and then for the RADT) Commercial name of the RADT: Strep A OIA (Biostar) Type of RADT: OIA
Target condition and reference standard(s)	Throat culture medium: standard culture and culture following incubation in a Todd‐Hewitt enrichment broth Atmosphere of incubation: aerobic Duration of incubation: 48 hours GAS confirmation: bacitracin disk +/‐ latex test Number of plates inoculated: 2 Assessment of GAS antibody response: no Relevant details: composite reference standard (office standard culture + laboratory enriched culture). Office tests (culture and RADT) were reviewed in the laboratory. The same swab was used for multiple purposes (office culture, RADT and lab culture).
Flow and timing	No follow‐up
Comparative
Type of study	Journal article
Notes	Supported by a grant from Biostar (manufacturer of the RADT)
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	High
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?	Unclear
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	High
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?	Yes
Were undetermined/uninterpretable results reported?	No
Were withdrawals from the study explained?	Yes
		Low