Roe 1995a.

Study characteristics
Patient sampling	Cross‐sectional study Prospective design Sample: unclear Direct comparison of different RADTs: yes Direct comparison of several throat culture techniques: yes (1 plate versus 2 plates versus enrichment broth) Person performing the throat sample: other ("clinical personnel") Exclusion if recent antibiotics use before inclusion: no Clinical selection of patients: none Presenting signs and symptoms: symptomatic pharyngitis Age range for inclusion: not reported ("children")
Patient characteristics and setting	Sample size: 500 Age (distribution): not reported GAS prevalence according to culture (with 95% confidence interval): 30.2% (95% CI not reported) Country of study: USA Sex (% of girls): not reported Clinical severity assessment: none Clinical setting: mixed (children's hospital clinic and emergency department) Single‐centre study
Index tests	Throat swab: 2 different swabs (each 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: inhibitory and enrichment Atmosphere of incubation: aerobic Duration of incubation: 48 hours GAS confirmation: latex test Number of plates inoculated: 2 or 3 Assessment of GAS antibody response: no Relevant details: 2 swabs were taken for each patient. Each swab was used for culture on a selective medium and then for antigen detection by one or the other RADTs. If both selective plates were negative for GAS, the pledgets were incubated in a Todd‐Hewitt enrichment broth with subsequent culture. The reference standard was the isolation of GAS by any one (or more than one) of the plates.
Flow and timing	No follow‐up
Comparative
Type of study	Journal article
Notes	A co‐author was affiliated with the manufacturer of one of the RADTs under evaluation (Abbott)
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	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?	No
		Low	High
DOMAIN 3: Reference Standard
Were culture results interpreted with blinding of the results of the RADT?	Yes
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
		Low	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?	Yes
Did patients receive the same throat culture method?	No
Were undetermined/uninterpretable results reported?	No
Were withdrawals from the study explained?	Yes
		Low