{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T16:10:42Z","timestamp":1765728642056},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:sec>\n            <jats:title>Objective<\/jats:title>\n            <jats:p>Current guidelines recommend confirmatory testing for negative rapid antigen detection tests (RADTs) for group A streptococcal pharyngitis in children. We sought to describe the work of follow-up generated by this process and frequency of our inability to notify patients of positive results.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>We retrospectively reviewed laboratory and outreach nurse records of patients who had group A streptococcal pharyngitis testing performed in an academic pediatric emergency department during 2014. For patients with a negative RADT and subsequent positive backup direct nucleic acid probe test, we recorded whether the patient was successfully notified of the positive result, the number of contact attempts, and the time to antibiotic prescription.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>There were 6504 patients who had an RADT performed, of which 5474 (84.2%) were negative with a confirmatory test performed. There were 234 patients with positive confirmatory testing and not prescribed antibiotics at the time of the initial visit. Of these, 90.1% were ultimately contacted and prescribed appropriate antibiotics, whereas 7.3% were lost to follow-up and 2.6% had potentially unnecessary repeat visits. Of those contacted, 43.1% were reached only after multiple telephone calls or a letter. The median time from the negative RADT to the submission of an electronic prescription was 19.6 hours (interquartile range, 7.5\u201324.9 hours; range, 6\u2013144 hours).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Although confirmatory testing after a negative RADT in children is currently the standard of care, this practice requires a substantial amount of work. Furthermore, a significant fraction of patients are lost to follow-up or have unnecessary repeat visits.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/pec.0000000000001144","type":"journal-article","created":{"date-parts":[[2017,5,31]],"date-time":"2017-05-31T17:10:15Z","timestamp":1496250615000},"page":"252-255","source":"Crossref","is-referenced-by-count":6,"title":["The Challenge of Patient Notification and the Work of Follow-Up Generated by a 2-Step Testing Protocol for Group A Streptococcal Pharyngitis in the Pediatric Emergency Department"],"prefix":"10.1097","volume":"35","author":[{"given":"Michael E.","family":"Russo","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, The Children's Hospital of Philadelphia, Philadelphia, PA; Divisions of"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Kline","sequence":"additional","affiliation":[{"name":"Emergency Medicine,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Preeti","family":"Jaggi","sequence":"additional","affiliation":[{"name":"Infectious Diseases, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy L.","family":"Leber","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel M.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Emergency Medicine,"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"bib1-20230930","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1542\/peds.2014-1094","article-title":"Rapid diagnostic tests for group A streptococcal pharyngitis: a meta-analysis","volume":"134","year":"2014","journal-title":"Pediatrics"},{"key":"bib2-20230930","doi-asserted-by":"crossref","first-page":"e86","DOI":"10.1093\/cid\/cis629","article-title":"Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America","volume":"55","year":"2012","journal-title":"Clin Infect Dis"},{"key":"bib3-20230930","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1542\/peds.2007-0484","article-title":"Burden and economic cost of group A streptococcal pharyngitis","volume":"121","year":"2008","journal-title":"Pediatrics"},{"key":"bib4-20230930","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1006\/pmed.2002.1062","article-title":"Cost-effectiveness of treatment options for prevention of rheumatic heart disease from group A streptococcal pharyngitis in a pediatric population","volume":"35","year":"2002","journal-title":"Prev 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impact of a computerized system to report late-arriving laboratory results in the emergency department","volume":"16","year":"2000","journal-title":"Pediatr Emerg Care"},{"key":"bib9-20230930","doi-asserted-by":"crossref","first-page":"37","DOI":"10.3414\/ME09-01-0011","article-title":"The rate of missed test results in an emergency department: an evaluation using an electronic test order and results viewing system","volume":"49","year":"2010","journal-title":"Methods Inf Med"},{"key":"bib10-20230930","doi-asserted-by":"crossref","first-page":"2258","DOI":"10.1128\/JCM.00490-15","article-title":"Multicenter clinical evaluation of the novel Alere i Strep A isothermal nucleic acid amplification test","volume":"53","year":"2015","journal-title":"J Clin Microbiol"},{"key":"bib11-20230930","doi-asserted-by":"crossref","first-page":"1474","DOI":"10.1128\/JCM.00176-13","article-title":"Multicenter clinical evaluation of the illumigene group A streptococcus DNA amplification assay for 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