Mirza 2007a.
| Study characteristics | |||
| Patient sampling | Cross‐sectional study
Retrospective design
Sample: unclear
Direct comparison of different RADTs: no
Direct comparison of several throat culture techniques: no
Person performing the throat sample: nurses and medical assistants Exclusion if recent antibiotics use before inclusion: no Clinical selection of patients: unclear Presenting signs and symptoms: unclear Age range for inclusion: < 18 years |
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| Patient characteristics and setting | Sample size: total 11,644 (only 9032 included in the meta‐analysis, i.e., those with RADT negative results also cultured)
Age (distribution): not reported GAS prevalence according to culture (with 95% confidence interval): 28.3% (95% CI not reported) Country of study: USA Sex (% of girls): not reported Clinical severity assessment: none Clinical setting: office‐based Multi‐centre study |
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| Index tests | Throat swab: 2 different swabs (1 swab for culture, 1 swab for performing the RADT) Commercial name of the RADT: QTest (Becton Dickinson) Type of RADT: EIA (liposomal test) |
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| Target condition and reference standard(s) | Throat culture medium: standard Atmosphere of incubation: aerobic with CO2 enrichment Duration of incubation: not reported GAS confirmation: not reported 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 study was sub‐divided into 2 study cohorts (Mirza 2007a and Mirza 2007b). In Mirza 2007a, the data came from 3 paediatric practices and the RADT used was the QTest (Abbott). In Mirza 2007b, the data came from a children's hospital and the RADT used was the Signify (Abbott). Throat culture performed only for children with negative RADT results (partial verification). | ||
| 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? | Unclear | ||
| Were patients seen in an ambulatory care setting? | Yes | ||
| High | Unclear | ||
| 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)? | Unclear | ||
| Were the culture medium, atmosphere, duration of incubation and GAS‐confirmation technique described? | No | ||
| 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? | No | ||
| Did patients receive the same throat culture method? | Yes | ||
| Were undetermined/uninterpretable results reported? | No | ||
| Were withdrawals from the study explained? | Yes | ||
| High | |||