Evidence map›Paper›PMID 19742330›Full record

SynthesisPloS one2009

Treatment outcomes of multidrug-resistant tuberculosis: a systematic review and meta-analysis.

James C Johnston, Neal C Shahidi, Mohsen Sadatsafavi, J Mark Fitzgerald

Registry-linked trialAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in PloS one, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02129244 (A Nurse Case Management Intervention to Improve MDR-TB/HIV Co-Infection Outcomes), which is not on this map. Cited by 189 papers, 22 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
189citing papers in PubMed, 22 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.

NCT02129244 naactive not recruitingnot on this mapstarted 2014, after this paper: background citation

A Nurse Case Management Intervention to Improve MDR-TB/HIV Co-Infection Outcomes

TypeinterventionalSponsorJohns Hopkins UniversityRan2014 to 2026Enrolled3,600ConditionsMDR-TB, HIVArmsNCM-Plus
3 · Its place in the literature

Who cites it

189 citing papers in PubMed, 22 syntheses or guidelines pooled it.

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  19. Fluoroquinolones for treating tuberculosis (presumed drug-sensitive).The Cochrane database of systematic reviews · 2013
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129 more citing papers are in PubMed but not listed here.

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

4 authors.

James C JohnstonTuberculosis Control, British Columbia Centre for Disease Control, Vancouver, Canada. johnst22@interchange.ubc.ca
Neal C Shahidi
Mohsen Sadatsafavi
J Mark Fitzgerald

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTreatment outcomes for multidrug-resistant Mycobacterium Tuberculosis (MDRTB) are generally poor compared to drug sensitive disease. We sought to estimate treatment outcomes and identify risk factors associated with poor outcomes in patients with MDRTB. METHODOLOGY/PRINCIPAL

findingsWe performed a systematic search (to December 2008) to identify trials describing outcomes of patients treated for MDRTB. We pooled appropriate data to estimate WHO-defined outcomes at the end of treatment and follow-up. Where appropriate, pooled covariates were analyzed to identify factors associated with worse outcomes. Among articles identified, 36 met our inclusion criteria, representing 31 treatment programmes from 21 countries. In a pooled analysis, 62% [95% CI 57-67] of patients had successful outcomes, while 13% [9]-[17] defaulted, 11% [9]-[13] died, and 2% [1]-[4] were transferred out. Factors associated with worse outcome included male gender 0.61 (OR for successful outcome) [0.46-0.82], alcohol abuse 0.49 [0.39-0.63], low BMI 0.41[0.23-0.72], smear positivity at diagnosis 0.53 [0.31-0.91], fluoroquinolone resistance 0.45 [0.22-0.91] and the presence of an XDR resistance pattern 0.57 [0.41-0.80]. Factors associated with successful outcome were surgical intervention 1.91 [1.44-2.53], no previous treatment 1.42 [1.05-1.94], and fluoroquinolone use 2.20 [1.19-4.09]. CONCLUSIONS/SIGNIFICANCE: We have identified several factors associated with poor outcomes where interventions may be targeted. In addition, we have identified high rates of default, which likely contributes to the development and spread of MDRTB.

Indexed as

AgedAged, 80 and overAlcoholismAnti-Bacterial AgentsBody Mass IndexClinical Trials as TopicDrug Resistance, BacterialFemaleFluoroquinolonesHumansMaleMiddle AgedResearch DesignRisk FactorsTreatment OutcomeTuberculosis, Multidrug-ResistantAnti-Bacterial AgentsFluoroquinolones

Identifiers

PMID19742330
PMCPMC2735675

What OpenQuestion holds

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Registered trials

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.