TY - JOUR
T1 - Optical immunoassay test for group A β-hemolytic streptococcal pharyngitis
T2 - An office-based, multicenter investigation
AU - Gerber, Michael A.
AU - Tanz, Robert R.
AU - Kabat, William
AU - Dennis, Elizabeth
AU - Bell, Gillian L.
AU - Kaplan, Edward L.
AU - Shulman, Stanford T.
PY - 1997/3/19
Y1 - 1997/3/19
N2 - Objective. - To compare the accuracy of an optical immunoassay (OIA) for the rapid diagnosis of group A streptococcal pharyngitis with blood agar plate (BAP) culture. Design. - Blinded comparison with criterion standard. Setting. - A total of 6 private pediatricians' offices, 3 in Connecticut and 3 in Chicago, Ill. Patients. - A total of 2113 consecutive patients with acute pharyngitis, 983 in Connecticut and 1130 in Chicago. Main Outcome Measures. - The sensitivities and specificities of OIA and BAP culture (both performed and interpreted in the office) were determined using a research laboratory's interpretation of a combination of BAP culture and Todd-Hewitt broth (THB) culture of transport tube pledger as criterion standard. Results. - Among patients in Connecticut, the sensitivities of the OIA and BAP culture were 94% and 89%, respectively (P=.004), while the specificities were 96% and 99%, respectively (P=.001). Among patients in Chicago, the sensitivities of the OIA and BAP culture were 79% and 72%, respectively (P<.001) while the specificities were 89% and 99%, respectively (P<.001). In each of the 6 pediatricians' offices, the OIA was more sensitive than the BAP culture. Combining the data from Connecticut and Chicago, the overall sensitivities of the OIA and BAP culture were 84% and 78%, respectively (P<.001), while the specificities were 93% and 99%, respectively (P<.001). Conclusions. - The results of this comprehensive office-based investigation suggest that with adequately trained personnel, negative OIA test results may not always need to be routinely confirmed with BAP cultures.
AB - Objective. - To compare the accuracy of an optical immunoassay (OIA) for the rapid diagnosis of group A streptococcal pharyngitis with blood agar plate (BAP) culture. Design. - Blinded comparison with criterion standard. Setting. - A total of 6 private pediatricians' offices, 3 in Connecticut and 3 in Chicago, Ill. Patients. - A total of 2113 consecutive patients with acute pharyngitis, 983 in Connecticut and 1130 in Chicago. Main Outcome Measures. - The sensitivities and specificities of OIA and BAP culture (both performed and interpreted in the office) were determined using a research laboratory's interpretation of a combination of BAP culture and Todd-Hewitt broth (THB) culture of transport tube pledger as criterion standard. Results. - Among patients in Connecticut, the sensitivities of the OIA and BAP culture were 94% and 89%, respectively (P=.004), while the specificities were 96% and 99%, respectively (P=.001). Among patients in Chicago, the sensitivities of the OIA and BAP culture were 79% and 72%, respectively (P<.001) while the specificities were 89% and 99%, respectively (P<.001). In each of the 6 pediatricians' offices, the OIA was more sensitive than the BAP culture. Combining the data from Connecticut and Chicago, the overall sensitivities of the OIA and BAP culture were 84% and 78%, respectively (P<.001), while the specificities were 93% and 99%, respectively (P<.001). Conclusions. - The results of this comprehensive office-based investigation suggest that with adequately trained personnel, negative OIA test results may not always need to be routinely confirmed with BAP cultures.
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U2 - 10.1001/jama.277.11.899
DO - 10.1001/jama.277.11.899
M3 - Article
C2 - 9062328
AN - SCOPUS:0030981375
SN - 0098-7484
VL - 277
SP - 899
EP - 903
JO - JAMA
JF - JAMA
IS - 11
ER -