THROAT CULTURING has many variables, especially the media used and the atmosphere of incubation, that affect the sensitivity of the culture method used as the reference method to evaluate a given streptococcal antigen detection system. A study of an antigen detection system that does not consider these might be biased. If a study uses an insensitive "gold standard" culture method to evaluate a rapid method, this can result in the antigen detection system being evaluated erroneously to appear to be as sensitive as and, possibly, a valid substitute for the more time-consuming throat cultures.
In a study reported in this issue, Schlager et al1 paid careful attention to the complexities of throat culture techniques to conduct a thorough evaluation of a new optical immunoassay for the direct detection of group A β-hemolytic streptococci (GABHS) antigen in throat specimens. Because our article2 and most of the studies cited in
Wegner DL. Proper Evaluation of Rapid Antigen Detection Methods for Diagnosing Streptococcal Pharyngitis. Arch Pediatr Adolesc Med. 1996;150(3):241. doi:10.1001/archpedi.1996.02170280011001