Etiologic predictive value of a rapid immunoassay for detection of group A streptococcus antigen from throat swabs in patients presenting with a sore throat

Orda, U., Gunnarsson, R., Orda, S., Fitzgerald, M., Rofe, G., and Dargan, A. (2016) Etiologic predictive value of a rapid immunoassay for detection of group A streptococcus antigen from throat swabs in patients presenting with a sore throat. In: [Presented at the 2016 North American Primary Care Research Group Annual Meeting]. From: NAPCRG 2016: North American Primary Care Research Group Annual Meeting, 12-16 November 2016, Colorado Springs, CL, USA.

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Abstract

Context: A sore throat is a common symptom mainly caused by virus but also by a variety of bacteria such as group A betahaemolytic streptococci (GAS) often resulting in unnecessary antibiotic prescribing. Combinations of symptoms and scores are not specific enough to accurately sort out aetiology. Rapid diagnostic antigen tests (RADT) have demonstrated high sensitivity and specificity in detecting presence of GAS.

Objective: Establish the probability that finding of GAS in a RADT shows a true link between symptoms and GAS while considering carriers of GAS ill from a virus.

Design: Cross-sectional study comparing two groups.

Setting: Emergency department (ED) also managing primary health care cases in a remote rural town with 22,000 residents.

Patients/Participants: 101 consecutive children aged 3-15 years attending for a sore throat as the main complaint and 147 consecutive children of the same age attending the same ED for other reasons than an infection.

Main And Secondary Outcome Measures: Positive and negative Etiologic Predictive Value (EPV).

Results: Positive EPV was 98% (88-100%). Negative EPV was 98% (97-99%). The positive EPV depends on setting and findings in this study and may not be transferable to other settings. It was mathematically shown that negative EPV found in this study is valid in all other reasonable settings and hence can be transferred to any other setting.

Conclusions: The evaluated RADT (Alere Test Pack+Plus With OBC Strep A) is always useful to rule out GAS infection in patients with an uncomplicated sore throat. It is often, depending on setting, useful to rule in a GAS infection in these patients.

Item ID: 45365
Item Type: Conference Item (Abstract / Summary)
Keywords: predictive value of tests, sore throat, tonsillitis, point of care testing
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Additional Information:

A YouTube link to a recording of this presentation held by Ronny Gunnarsson, can be found in the Related URLs field.

Date Deposited: 31 Aug 2016 03:00
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111717 Primary Health Care @ 100%
SEO Codes: 92 HEALTH > 9202 Health and Support Services > 920203 Diagnostic Methods @ 100%
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