ArticleAnnals of internal medicine2008
Improved diagnostic evaluation of suspected tuberculosis.
Article in Annals of internal medicine, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 53 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
53 citing papers in PubMed, 2 syntheses or guidelines pooled it, 160 citations in OpenAlex.
- Accuracy of the Bronchoalveolar Lavage Enzyme-Linked Immunospot Assay for the Diagnosis of Pulmonary Tuberculosis: A Meta-analysis.Medicine · 2016Pooled it
- Systematic review: T-cell-based assays for the diagnosis of latent tuberculosis infection: an update.Annals of internal medicine · 2008Pooled it
- Bronchoalveolar lavage enzyme-linked immunospot for a rapid diagnosis of tuberculosis: a Tuberculosis Network European Trialsgroup study.American journal of respiratory and critical care medicine · 2009Trial
- Accuracy of immunodiagnostic tests for active tuberculosis using single and combined results: a multicenter TBNET-Study.PloS one · 2008Trial
- T cell immunity predicts clinical outcomes on stopping antiretroviral treatment after HIV-specific broadly neutralising antibody therapy.medRxiv : the preprint server for health sciences · 2026Article
- Clinical utilization of multiple antibodies ofAnnals of medicine · 2023Observational
- Nomogram to determine predictive risk for active tuberculosis based on the QuantiFERON-TB Gold In-Tube test.Scientific reports · 2023Article
- Latent Tuberculosis in India: An Overview.Cureus · 2023Review
- Defining the Role of Cellular Immune Signatures in Diagnostic Evaluation of Suspected Tuberculosis.The Journal of infectious diseases · 2022Article
- Effect of adjusted cut-offs of interferon-γ release assays on diagnosis of tuberculosis in patients with fever of unknown origin.Journal of clinical tuberculosis and other mycobacterial diseases · 2022Article
- Transcriptomic signatures for diagnosing tuberculosis in clinical practice: a prospective, multicentre cohort study.The Lancet. Infectious diseases · 2021Article
- Correlation between the tuberculin skin test and T-SPOT.TB in patients with suspected tuberculosis infection: A pilot study.Experimental and therapeutic medicine · 2019Article
- Diagnostic value of the interferon-γ release assay for tuberculosis infection in patients with Behçet's disease.BMC infectious diseases · 2019Article
- QuantiFERON-TB Gold In-tube test for the diagnosis of active and latent tuberculosis in selected health facilities of Addis Ababa, Ethiopia.BMC research notes · 2018Article
- ADJunctive Ulinastatin in Sepsis Treatment in China (ADJUST study): study protocol for a randomized controlled trial.Trials · 2018Article
- Article
- Novel interferon-gamma assays for diagnosing tuberculosis in young children in India.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2017Article
- Article
- Differences in antigen-specific CD4+ responses to opportunistic infections in HIV infection.Immunity, inflammation and disease · 2015Article
- Utility of EBUS-TBNA for diagnosis of mediastinal tuberculous lymphadenitis: a multicentre Australian experience.Journal of thoracic disease · 2015Article
Corrections and comments
- Commented on by
- Erratum issued
Authors and funding
11 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundThe role of new T-cell-based blood tests for tuberculosis in the diagnosis of active tuberculosis is unclear.
objectiveTo compare the performance of 2 interferon-gamma assays and tuberculin skin testing in adults with suspected tuberculosis.
designProspective study conducted in routine practice.
setting2 urban hospitals in the United Kingdom. PATIENTS: 389 adults, predominantly of South Asian and black ethnicity, with moderate to high clinical suspicion of active tuberculosis.
interventionTuberculin skin testing, the enzyme-linked immunospot assay (ELISpot) incorporating early secretory antigenic target-6 and culture filtrate protein-10 (standard ELISpot), and ELISpot incorporating a novel antigen, Rv3879c (ELISpot(PLUS)) were performed during diagnostic assessment by independent persons who were blinded to results of the other test. MEASUREMENTS: Sensitivity, specificity, predictive values, and likelihood ratios.
results194 patients had a final diagnosis of active tuberculosis, of which 79% were culture-confirmed. Sensitivity for culture confirmed and highly probable tuberculosis was 89% (95% CI, 84% to 93%) with ELISpot(PLUS), 85% (CI, 79% to 90%) with standard ELISpot, 79% (CI, 72% to 85%) with 15-mm threshold tuberculin skin testing, and 83% (CI, 77% to 89%) with stratified thresholds of 15 and 10 mm in vaccinated and unvaccinated patients, respectively. The ELISpot(PLUS) assay was more sensitive than tuberculin skin testing with 15-mm cutoff points (P = 0.01) but not with stratified cutoff points (P = 0.10). The ELISpot(PLUS) assay had 4% higher diagnostic sensitivity than standard ELISpot (P = 0.02). Combined sensitivity of ELISpot(PLUS) and tuberculin skin testing was 99% (CI, 95% to 100%), conferring a negative likelihood ratio of 0.02 (CI, 0 to 0.06) when both test results were negative. LIMITATIONS: Local standards for tuberculin skin testing differed from others used internationally. The study sample included few immunosuppressed patients.
conclusionThe ELISpot(PLUS) assay is more sensitive than standard ELISpot and, when used in combination with tuberculin skin testing, enables rapid exclusion of active infection in patients with moderate to high pretest probability of tuberculosis.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.