Mezghani Maleej 2010.

Study characteristics
Patient sampling	Cross‐sectional study Prospective design Sample: consecutive 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 Clinical selection of patients: implicit criteria (see below) Presenting signs and symptoms: acute pharyngitis, excluding those with signs suggesting viral aetiology Age range for inclusion: 2 to 10 years
Patient characteristics and setting	Sample size: 504 (445 participants in the contingency table) Age (distribution): mean = 5.7 years (range 2 years and 2 months to 10 years) GAS prevalence according to culture (with 95% confidence interval): 32.9% (95% CI not reported) Country of study: Tunisia Sex (% of girls): 46% Clinical severity assessment: McIsaac score Clinical setting: walk‐in clinic Single‐centre study
Index tests	Throat swab: 2 different swabs Commercial name of the RADT: OSOM Strep A Type of RADT: EIA
Target condition and reference standard(s)	Throat culture medium: standard and inhibitory (2 plates) Atmosphere of incubation: aerobic with CO2 enrichment Duration of incubation: 48 hours GAS confirmation: latex test Number of plates inoculated: 2 Assessment of GAS antibody response: no Relevant details: ‐
Flow and timing	No follow‐up
Comparative
Type of study	Journal article (in French)
Notes	We thank Prof. A Hammami for providing data from the contingency table (not extractable in the original publication)
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)?	Yes
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?	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?	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
		Unclear	Low
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?	Yes
Were withdrawals from the study explained?	Yes
		Low