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Vidya Sharma, MBBS, MPH; M. Denise Dowd, MD, MPH; Douglas S. Swanson, MD; Andrew J. Slaughter; Stephen D. Simon, PhD

Arch Pediatr Adolesc Med. 2003;157:257-260.

Objective  To examine the association between mass media attention regarding invasive group A streptococcal (GAS) disease and testing for GAS in a pediatric emergency department (ED).

Design, Setting, and Participants  An observational analysis was performed of patients who had GAS tests done in a pediatric ED between December 1, 1999, and November 30, 2001. Data were analyzed by dividing each of the 2 years into 4 consecutive 90-day intervals. Data including age, date of the visit, presenting complaint, primary discharge diagnosis, whether a GAS test was obtained, and the results were collected from an electronic data repository. The date of the news stories, the station, and the duration of the broadcast were collected from electronic archives of the local newspaper and a broadcast monitoring service.

Main Outcome Measure  The rate of GAS tests done per 1000 ED visits and the rate of positive tests per 1000 ED visits.

Results  An average of 103 GAS tests were performed per 1000 ED visits in the December through February period in year 2 compared with 55 GAS tests per 1000 ED visits in a similar period in year 1. This difference was statistically significant (difference, 48 tests; 95% confidence interval, 24-72 tests; P<.001). There were no significant differences in the proportion of positive tests (32% in year 1 vs 20% in year 2; mean difference, -11%; 95% confidence interval, -23% to 1%; P = .07). There were a total of 16 newspaper articles and 34 television stories on GAS during the 2-year study period. The peak in GAS tests and the peak in media events were concomitant.

Conclusion  A surge in news stories regarding GAS disease was associated with an increase in testing for GAS in a pediatric ED.

From the Departments of Pediatrics, Children's Mercy Hospital and University of Missouri School of Medicine at Kansas City (Drs Sharma, Dowd, Swanson, and Simon), and Department of Information Services, Children's Mercy Hospital (Mr Slaughter).

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