Kaufhold 1991a.

Study characteristics
Patient sampling	Cross‐sectional study Retrospective or prospective design: unclear Sample: unclear Direct comparison of different RADTs: yes Direct comparison of several throat culture techniques: no Person performing the throat sample: not reported Exclusion if recent antibiotics use before inclusion: data not extracted Clinical selection of patients: none Presenting signs and symptoms: suspicion of streptococcal pharyngitis Age range for inclusion: 0 to 16 years
Patient characteristics and setting	Sample size: 230 Age (distribution): not reported GAS prevalence according to culture (with 95% confidence interval): 45.6% (95% CI not reported) Country of study: Germany Sex (% of girls): not reported Clinical severity assessment: none Clinical setting: mixed (paediatric hospital and private offices) Multi‐centre study
Index tests	Throat swab: 1 double swab Commercial name of the RADT: TestPack Strep A Type of RADT: EIA
Target condition and reference standard(s)	Throat culture medium: standard Atmosphere of incubation: aerobic Duration of incubation: 24 to 48 hours GAS confirmation: latex test Number of plates inoculated (n): data not extracted Assessment of GAS antibody response: data not extracted Relevant details: ‐
Flow and timing	No follow‐up
Comparative
Type of study	Journal article (in German)
Notes	The manufacturers provided the rapid test kits. We thank Dr A Leis for translating this study report.
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?	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?	Unclear
Was the type of the RADT mentioned (EIA or OIA)?	Yes
Were RADTs conducted during consultation time?	No
		Unclear	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)?	No
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?	No
		Low