Training doubles Rapid Strep accuracy

[Buster]

Okay, okay, not double but it does seem to move from 56% to 90%....

 

---

 

I was searching for something else and ran across this paper:

Performance of Rapid Streptococcal Antigen Testing Varies by Personnel http://www.ncbi.nlm.nih.gov/pmc/articles/P...29/?tool=pubmed

 

This paper found that most non-lab personnel (i.e., nurses and even doctors) didn't do a great job at getting a throat swab. The non-lab folks had a sensitivity of only 56-60% (i.e., relative to a check by lab or by a backup culture). After training the non-lab folks improved to 75-82%. Lab trained individuals we in the 88-90% range.

 

Bottom line, the accuracy of the test is highly dependent on getting a good sample...

 

Buster

[thereishope]

And it's hard to get a good sample when it takes 4 nurses and a dad to hold a child down, pry open their mouth and actually get the swab.

[memom]

No doubt

[kim]

I noticed the last two times that I phoned Dr. office to check cultured strep results I was told that it showed "within normal limits." Over the years, I have always gotten a "positive or negative," response. Does anyone know if there is an acceptable amt. of strep that can show up in a culture, or should there be "none" if you are negative? Have they changed anything recently with regards to classification of a negative culture?

[tantrums]

And it's hard to get a good sample when it takes 4 nurses and a dad to hold a child down, pry open their mouth and actually get the swab.

 

 

Had to chuckle here because that was my first thought as well! My son would normally submit to ANY medical test, but if he even THINKS a throat swab will be involved it's "GAME ON!"

[melanie]

Ok So If this is true and we know it is what do we do? What can we saw to the nurse or nurses assistant(thats who always does ours) so they get a more accurate swab? And also when they are positive are they worsre?

melanie

[peglem]

Ok So If this is true and we know it is what do we do? What can we saw to the nurse or nurses assistant(thats who always does ours) so they get a more accurate swab? And also when they are positive are they worsre?

melanie

I have noticed neg tests (when I knew my daughter was streppy- from behaviors) results when nurses have been too "gentle" with the swab. And we do have quite a tussle with getting the swab (if we don't, you can safely assume it will be negative). Anyway, I always tell the nurses that its okay if my child gags- if you're going to go to all this trouble to run the test, I want to make sure its really accurate.

[smartyjones]

in light of a recent flu-induced exacerbation with negative rapid and culture, i had already been wondering how much i can trust that culture.

 

so where does this leave us relative to dr. T's recent post cautioning

• "Strep STILL HAS TO BE AGGRESSSIVELY ELIMINATED once immune cool-down completed"
  

- if one has shown high titers, can that be an accurate test to ensure strep is eliminated if those titers are falling?

- can we go off behavior?

 

HOW are we sure strep is eliminated?

[thereishope]

I actually get mad when they know I have a PANDAS child, they see him acting like a crazed animal and they still think they need a strep test. Obviously, he has strep. When he isn't in an exacerbation, he'll sit there and open his mouth for them. Not that he likes it, but he'll have that reasoning, "must do" mentality. That's gone when PANDAS surfaces. Once, I had to argue with them because they wanted to check his weight prior to the strep test and he refused. I was trying to tackle him to take his shoes off and the nurse just stood there. I finally demanded that they ask the doctor if they needed his weight. He just had it checked like 2 weeks prior. So the nurse finally left and asked. Came back and told me they didn't need his weight after all. I hate going to the ped's office.

 

 

 

And it's hard to get a good sample when it takes 4 nurses and a dad to hold a child down, pry open their mouth and actually get the swab.

 

 

Had to chuckle here because that was my first thought as well! My son would normally submit to ANY medical test, but if he even THINKS a throat swab will be involved it's "GAME ON!"