THE EFFECT OF A RAPID KIT FOR DETECTION OF STREPTOCOCCAL PHARYNGITIS ON THE ACCURACY OF THE PHYSICIANS DIAGNOSES

Background: In the last decade, the accuracy of rapid tests for detect ion of group A streptococcal antigen was evaluated in laboratory and c linical settings, and the tests were suggested as an alternative to th e traditional throat culture. Methods: We evaluated 19 patients with a preliminary diagnosis of non-streptococcal pharyngitis and 13 patient s with a preliminary diagnosis of streptococcal pharyngitis. The physi cian performed a rapid latex agglutination test (Detect A Strep), took throat culture from all of the patients, reconsidered the preliminary diagnosis, and made a working diagnosis. A clinical score was calcula ted for each patient during data analysis. The accuracy of the physici ans' preliminary diagnoses was compared with the accuracy of the scori ng system, with the accuracy of the latex agglutination test, and with the accuracy of the physicians' working diagnoses, Results: The scori ng system, the physicians' preliminary diagnoses, the latex agglutinat ion test, and the physicians' working diagnoses correlated significant ly with throat culture results (p less than or equal to 0.05), The eff iciency of the physicians' preliminary diagnoses was 75% compared with an efficiency of 69% of the clinical scoring system, an efficiency of 66% of the latex agglutination test, and an efficiency of 69% of the physicians' working diagnoses. The physician changed the preliminary d iagnosis only for two patients as a result of the latex agglutination test results; ironically, however, the preliminary diagnosis was corre ct in both of these cases. Conclusion: The use of a rapid test for the diagnosis of group A streptococcal antigen under normal working condi tions did not improve the accuracy of the physician's diagnosis, so th e use of the latex agglutination test in this study was not cost-effec tive.