Wright 2007a.

Study characteristics
Patient sampling	Cross‐sectional study Prospective design Sample: unclear Direct comparison of different RADTs: yes (2 EIAs) Direct comparison of several throat culture techniques: no Person performing the throat sample: other ("medical technician") Exclusion if recent antibiotics use before inclusion: no Clinical selection of patients: explicit criteria but not a score (see below) Presenting signs and symptoms: "Criteria for throat swab included sore throat, erythematous tonsils or pharynx, cervical lymphadenopathy, and exudates" Age range for inclusion: 0 to 18 years
Patient characteristics and setting	Sample size: 338 Age (distribution): not reported GAS prevalence according to culture (with 95% confidence interval): 26.0% (95% CI not reported) Country of study: USA Sex (% of girls): not reported Clinical severity assessment: none Clinical setting: military air force base Single‐centre study
Index tests	Throat swab: 1 double swab (each swab used for antigen detection and culture) Commercial name of the RADT: OSOM Ultra Strep A Type of RADT: EIA
Target condition and reference standard(s)	Throat culture medium: standard Atmosphere of incubation: aerobic Duration of incubation: 48 hours GAS confirmation: not reported Number of plates inoculated: not reported Assessment of GAS antibody response: no Relevant details: unclear if the reference standard was a single‐plate culture or a composite of both plates.
Flow and timing	No follow‐up
Comparative
Type of study	Journal article
Notes	—
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)?	Yes
Was clinical selection of patients avoided?	Unclear
Were patients seen in an ambulatory care setting?	No
		Unclear	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?	Unclear
		Low	Unclear
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?	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?	Yes
Did patients receive the same throat culture method?	Yes
Were undetermined/uninterpretable results reported?	No
Were withdrawals from the study explained?	Yes
		Low