Evidence map›Paper›PMID 18612425›Full record

ArticlePloS one2008

A three-way comparison of tuberculin skin testing, QuantiFERON-TB gold and T-SPOT.TB in children.

Tom G Connell, Nicole Ritz, Georgia A Paxton, Jim P Buttery, Nigel Curtis, Sarath C Ranganathan

Abstract readComparative StudyEvaluation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in PloS one, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
54citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

54 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Evaluation of interferon-gamma release assays for the diagnosis of tuberculosis: an updated meta-analysis.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2012
    Pooled it
  4. Tuberculous dactylitis--an easily missed diagnosis.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2011
    Pooled it
  5. Discordance among commercially available diagnostics for latent tuberculosis infection.American journal of respiratory and critical care medicine · 2012
    Trial
  6. Trial
  7. Article
  8. Review
  9. Review
  10. Article
  11. Review
  12. Tuberculosis Infection in Children and Adolescents.Pathogens (Basel, Switzerland) · 2022
    Review
  13. Article
  14. Article
  15. Article
  16. Pediatric Tuberculosis: The Impact of "Omics" on Diagnostics Development.International journal of molecular sciences · 2020
    Review
  17. Article
  18. Article
  19. Article
  20. Journal of clinical tuberculosis and other mycobacterial diseases · 2019
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Tom G ConnellDepartment of Paediatrics, University of Melbourne, Royal Children's Hospital Melbourne, Parkville, Victoria, Australia.
Nicole Ritz
Georgia A Paxton
Jim P Buttery
Nigel Curtis
Sarath C Ranganathan

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere are limited data comparing the performance of the two commercially available interferon gamma (IFN-gamma) release assays (IGRAs) for the diagnosis of tuberculosis (TB) in children. We compared QuantiFERON-TB gold In Tube (QFT-IT), T-SPOT.TB and the tuberculin skin test (TST) in children at risk for latent TB infection or TB disease. METHODS AND

findingsThe results of both IGRAs were compared with diagnosis assigned by TST-based criteria and assessed in relation to TB contact history. Results from the TST and at least one assay were available for 96 of 100 children. Agreement between QFT-IT and T-SPOT.TB was high (93% agreement, kappa = 0.83). QFT-IT and T-SPOT.TB tests were positive in 8 (89%) and 9 (100%) children with suspected active TB disease. There was moderate agreement between TST and either QFT-IT (75%, kappa = 0.50) or T-SPOT.TB (75%, kappa = 0.51). Among 38 children with TST-defined latent TB infection, QFT-IT gold and T-SPOT.TB assays were positive in 47% and 39% respectively. Three TST-negative children were positive by at least one IGRA. Children with a TB contact were more likely than children without a TB contact to have a positive IGRA (QFT-IT LR 3.9; T-SPOT.TB LR 3.9) and a positive TST (LR 1.4). Multivariate linear regression analysis showed that the magnitude of both TST induration and IGRA IFN-gamma responses was significantly influenced by TB contact history, but only the TST was influenced by age.

conclusionsAlthough a high level of agreement between the IGRAs was observed, they are commonly discordant with the TST. The correct interpretation of a negative assay in a child with a positive skin test in clinical practice remains challenging and highlights the need for longitudinal studies to determine the negative predictive value of IGRAs.

Indexed as

AdolescentChildData Interpretation, StatisticalFemaleHumansInterferon-gammaMaleSensitivity and SpecificityTuberculin TestTuberculosisInterferon-gamma

Identifiers

PMID18612425
PMCPMC2440545

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Registered trials

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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.