Sensitivity and Specificity of Rapid Antigen Detection Testing for                     Diagnosing Pharyngitis in the Emergency Department

Sarıkaya, Sezgin; Aktaş, Can; Ay, Dıdem; Çetin, Aslı Çakır; Celikmen, Ferudun

doi:10.1177/014556131008900410

Cited by 14 publications

(9 citation statements)

References 11 publications

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“…Of the 59 studies, 43 (72.9%; 18,464 patients) fulfilled the higher quality definition [24]–[29], [31]–[34], [36]–[38], [41]–[46], [48], [49], [53], [54], [56], [57], [59]–[62], [64], [65], [67]–[71], [73], [75]–[79], [81] and 16 (27.1%; 35,634 patients) did not [28], [30], [35], [39], [40], [47], [50], [51], [58], [63], [66], [72], [74], [80]. The coupled forest plots for sensitivity and specificity and HSROC are shown for higher quality studies (Figure S2 in File S2, Figure S4 in File S2) and lower quality studies (Figure S3 in File S2, Figure S4 in File S2).…”

Section: Resultsmentioning

confidence: 99%

“…The pooled sensitivity was 91% (95% CI, 87–94%) and the pooled specificity was 93% (95% CI, 92 to 95%). One outlier study [75] met 12 quality criteria (Table S3 in File S1) and enrolled 100 patients presenting to an emergency room in Istanbul [75]. Another outlier study, [29] met nine quality criteria (Table S3 in File S1) and enrolled 148 patients presenting to two primary care settings in Boston (Massachusetts).…”

Section: Resultsmentioning

confidence: 99%

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Rapid Antigen Group A Streptococcus Test to Diagnose Pharyngitis: A Systematic Review and Meta-Analysis

et al. 2014

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BackgroundPharyngitis management guidelines include estimates of the test characteristics of rapid antigen streptococcus tests (RAST) using a non-systematic approach.ObjectiveTo examine the sensitivity and specificity, and sources of variability, of RAST for diagnosing group A streptococcal (GAS) pharyngitis.Data SourcesMEDLINE, Cochrane Reviews, Centre for Reviews and Dissemination, Scopus, SciELO, CINAHL, guidelines, 2000–2012.Study SelectionCulture as reference standard, all languages.Data Extraction and SynthesisStudy characteristics, quality.Main Outcome(s) and Measure(s)Sensitivity, specificity.ResultsWe included 59 studies encompassing 55,766 patients. Forty three studies (18,464 patients) fulfilled the higher quality definition (at least 50 patients, prospective data collection, and no significant biases) and 16 (35,634 patients) did not. For the higher quality immunochromatographic methods in children (10,325 patients), heterogeneity was high for sensitivity (inconsistency [I2] 88%) and specificity (I2 86%). For enzyme immunoassay in children (342 patients), the pooled sensitivity was 86% (95% CI, 79–92%) and the pooled specificity was 92% (95% CI, 88–95%). For the higher quality immunochromatographic methods in the adult population (1,216 patients), the pooled sensitivity was 91% (95% CI, 87 to 94%) and the pooled specificity was 93% (95% CI, 92 to 95%); however, heterogeneity was modest for sensitivity (I2 61%) and specificity (I2 72%). For enzyme immunoassay in the adult population (333 patients), the pooled sensitivity was 86% (95% CI, 81–91%) and the pooled specificity was 97% (95% CI, 96 to 99%); however, heterogeneity was high for sensitivity and specificity (both, I2 88%).ConclusionsRAST immunochromatographic methods appear to be very sensitive and highly specific to diagnose group A streptococcal pharyngitis among adults but not in children. We could not identify sources of variability among higher quality studies. The present systematic review provides the best evidence for the wide range of sensitivity included in current guidelines.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Rapid Antigen Group A Streptococcus Test to Diagnose Pharyngitis: A Systematic Review and Meta-Analysis

et al. 2014

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“…Positive Predictive Value of RADT was 65.2% (19), 80.95% (20), 95.0% (21) respectively, our test had 36.4% Positive Predictive Value. It is lower than all other studies.…”

Section: Discussionmentioning

confidence: 62%

“…Specificities of RADT tests were between 89.7% and 99% (18)(19)(20)(21)(22). Sensitivities of tests are between 64.6% and 68.2% which are similar to our result (18)(19)(20). Two studies had sensitivities of 89.7% (21) and 100% (22) which were higher than our result.…”

Section: Discussionmentioning

confidence: 99%

The Sensitivity and the Specifity of Rapid Antigen Test in Group A Streptococcal Tonsillopharyngitis

Çoban¹,

Kaplan²,

Topal³

et al. 2013

J Pediatr Inf

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ÖzetAmaç: En sık doktora veya sağlık kuruluşuna başvuru sebeplerinden birisi akut tonsillofarenjittir. Grup A streptokoklar (GAS), tüm tonsillofarenjit vakalarının %15-36'sından sorumludur. Hızlı antijen tarama testi ve boğaz kültürü hastalığın tanısal testleridir. Biz çalışmamızda hızlı antijen tarama testi ve boğaz kültürünün pozitiflik oranlarını; hızlı antijen tarama testinin duyarlılık ve özgüllük oranlarını saptamayı amaçladık. Gereç veYöntemler: Nisan 2008-Mart 2013 tarihleri arasında 6310 boğaz kültürü ve 4124 hızlı antijen tarama testi çalışılmıştır. Hastaların boğazlarından iki sürüntü örneği alınmıştır. İlk sürüntü, Ecotest ® strep A hızlı test kiti (Wellkang, İngiltere) veya SD ® hızlı test kit (Standard Diagnostic, Kore) kullanılarak çalışılmıştır. Boğaz kültürleri %5 koyun kanlı agarına ekilmiştir. Bulgular: Beş yıllık süreçte 434 (%10,5) hastada hızlı antigen testi pozitif bulunurken, 266 (%4,2) hastada boğaz kültüründe Grup A streptokok üremesi olmuştur. Toplam 2163 hastada boğaz kültürü ve hızlı antijen tarama testi birlikte çalışılmıştır. Sonuç: Hızlı antijen tarama testinin duyarlılığı %68,1 ve özgüllüğü %92,2 bulunmuştur. Pozitif ve negatif prediktif (tahmini) değerleri sırasıyla %36,4 ve %97,8 bulunmuştur. (J Pediatr Inf 2013; 7: 143-6) Anahtar kelimeler: Grup A streptokok, tonsillofarenjit, çocuklar, hızlı antijen tarama testi AbstractObjective: Acute tonsillopharyngitis is one of the most common reasons for doctor visits and medical care demand, and Group A streptococcus (GAS) is responsible for 15% to 36% of cases. Available diagnostic tests include throat culture and rapid antigen detection testing. We aim to detect the sensitivity and specificity of the rapid antigen detection test in Group A streptococcal tonsillopharyngitis, ratio of positive throat culture and rapid antigen detection tests. Material and Methods: From April 2008 through March 2013, 6310 throat cultures and 4124 rapid antigen detection tests (RADT) were tested for GAS. The throat culture samples were taken with two swabs and the samples processed using the Ecotest strep A Rapid Test Device (Wellkang, UK) or SD rapid test kit (Standard Diagnostic, Korea). The samples of the patients for throat culture were cultivated in 5% sheep blood agar. Results: In five years, RADT was detected positive in 434 (10.5%) patients, 266 (4.2%) throat cultures were positive for GAS. In the five year period, 2163 tests worked simultaneously for RADT and throat culture. Conclusion: Sensitivity and specificity of our RADT test was 68.1% and 92.2% respectively. Positive and Negative Predictive Value of RADT was 36.4% and 97.8% respectively. (J Pediatr Inf 2013; 7: 143-6)

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“…The current gold standard for diagnosis of GAS pharyngitis is throat culture on blood agar plate over a period of 48 hours (Shulman et al, 2012;Choby, 2009;Gerber, 2005). However, rapid antigen detection tests (RADTs) have been developed to reduce time to diagnosis and thus administration of appropriate therapy (Flores Mateo et al, 2010;Madurell et al, 2010;Sarikaya et al, 2010). The RADT principle is based upon immunoassay detection of the Lancefield group A antigen.…”

Section: Introductionmentioning

confidence: 99%

In vitro evaluation and comparison of 5 rapid antigen detection tests for the diagnosis of beta-hemolytic group A streptococcal pharyngitis

Plainvert

Duquesne

Touak

et al. 2015

Diagnostic Microbiology and Infectious Disease

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Sensitivity and Specificity of Rapid Antigen Detection Testing for Diagnosing Pharyngitis in the Emergency Department

Cited by 14 publications

References 11 publications

Rapid Antigen Group A Streptococcus Test to Diagnose Pharyngitis: A Systematic Review and Meta-Analysis

Rapid Antigen Group A Streptococcus Test to Diagnose Pharyngitis: A Systematic Review and Meta-Analysis

The Sensitivity and the Specifity of Rapid Antigen Test in Group A Streptococcal Tonsillopharyngitis

In vitro evaluation and comparison of 5 rapid antigen detection tests for the diagnosis of beta-hemolytic group A streptococcal pharyngitis

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