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Rapid antigen detection test for group A streptococcus in children with pharyngitis

Overview of attention for article published in Cochrane database of systematic reviews, July 2016
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (96th percentile)
  • High Attention Score compared to outputs of the same age and source (88th percentile)

Mentioned by

news
1 news outlet
blogs
1 blog
policy
1 policy source
twitter
96 tweeters
facebook
2 Facebook pages
googleplus
1 Google+ user

Citations

dimensions_citation
28 Dimensions

Readers on

mendeley
184 Mendeley
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Title
Rapid antigen detection test for group A streptococcus in children with pharyngitis
Published in
Cochrane database of systematic reviews, July 2016
DOI 10.1002/14651858.cd010502.pub2
Pubmed ID
Authors

Jérémie F Cohen, Nathalie Bertille, Robert Cohen, Martin Chalumeau

Abstract

Group A streptococcus (GAS) accounts for 20% to 40% of cases of pharyngitis in children; the remaining cases are caused by viruses. Compared with throat culture, rapid antigen detection tests (RADTs) offer diagnosis at the point of care (within five to 10 minutes). To determine the diagnostic accuracy of RADTs for diagnosing GAS in children with pharyngitis. To assess the relative diagnostic accuracy of the two major types of RADTs (enzyme immunoassays (EIA) and optical immunoassays (OIA)) by indirect and direct comparison. We searched CENTRAL, MEDLINE, EMBASE, Web of Science, CDSR, DARE, MEDION and TRIP (January 1980 to July 2015). We also conducted related citations tracking via PubMed, handsearched reference lists of included studies and relevant review articles, and screened all articles citing included studies via Google Scholar. We included studies that compared RADT for GAS pharyngitis with throat culture on a blood agar plate in a microbiology laboratory in children seen in ambulatory care. Two review authors independently screened titles and abstracts for relevance, assessed full texts for inclusion, and carried out data extraction and quality assessment using the QUADAS-2 tool. We used bivariate meta-analysis to estimate summary sensitivity and specificity, and to investigate heterogeneity across studies. We compared the accuracy of EIA and OIA tests using indirect and direct evidence. We included 98 unique studies in the review (116 test evaluations; 101,121 participants). The overall methodological quality of included studies was poor, mainly because many studies were at high risk of bias regarding patient selection and the reference standard used (in 73% and 43% of test evaluations, respectively). In studies in which all participants underwent both RADT and throat culture (105 test evaluations; 58,244 participants; median prevalence of participants with GAS was 29.5%), RADT had a summary sensitivity of 85.6%; 95% confidence interval (CI) 83.3 to 87.6 and a summary specificity of 95.4%; 95% CI 94.5 to 96.2. There was substantial heterogeneity in sensitivity across studies; specificity was more stable. There was no evidence of a trade-off between sensitivity and specificity. Heterogeneity in accuracy was not explained by study-level characteristics such as whether an enrichment broth was used before plating, mean age and clinical severity of participants, and GAS prevalence. The sensitivity of EIA and OIA tests was comparable (summary sensitivity 85.4% versus 86.2%). Sensitivity analyses showed that summary estimates of sensitivity and specificity were stable in low risk of bias studies. In a population of 1000 children with a GAS prevalence of 30%, 43 patients with GAS will be missed. Whether or not RADT can be used as a stand-alone test to rule out GAS will depend mainly on the epidemiological context. The sensitivity of EIA and OIA tests seems comparable. RADT specificity is sufficiently high to ensure against unnecessary use of antibiotics. Based on these results, we would expect that amongst 100 children with strep throat, 86 would be correctly detected with the rapid test while 14 would be missed and not receive antibiotic treatment.

Twitter Demographics

The data shown below were collected from the profiles of 96 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 184 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Jamaica 1 <1%
United Kingdom 1 <1%
United States 1 <1%
Canada 1 <1%
Unknown 180 98%

Demographic breakdown

Readers by professional status Count As %
Student > Doctoral Student 38 21%
Student > Master 25 14%
Student > Ph. D. Student 22 12%
Other 22 12%
Student > Bachelor 21 11%
Other 56 30%
Readers by discipline Count As %
Medicine and Dentistry 108 59%
Unspecified 19 10%
Nursing and Health Professions 12 7%
Biochemistry, Genetics and Molecular Biology 8 4%
Agricultural and Biological Sciences 8 4%
Other 29 16%

Attention Score in Context

This research output has an Altmetric Attention Score of 75. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 10 November 2018.
All research outputs
#227,188
of 13,570,857 outputs
Outputs from Cochrane database of systematic reviews
#554
of 10,637 outputs
Outputs of similar age
#8,155
of 260,094 outputs
Outputs of similar age from Cochrane database of systematic reviews
#16
of 140 outputs
Altmetric has tracked 13,570,857 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 98th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 10,637 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 21.1. This one has done particularly well, scoring higher than 94% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 260,094 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 96% of its contemporaries.
We're also able to compare this research output to 140 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 88% of its contemporaries.