Evidence map›Paper›PMID 20510279›Full record

SynthesisThe Lancet. Infectious diseases2010

Sputum monitoring during tuberculosis treatment for predicting outcome: systematic review and meta-analysis.

David J Horne, Sarah E Royce, Lisa Gooze, Masahiro Narita, Philip C Hopewell, Payam Nahid, Karen R Steingart

2 registry-linked trialsAbstract readEvaluation StudyMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The Lancet. Infectious diseases, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 139 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
139citing papers in PubMed, 7 pooled it
7.2field-weighted citation impact, top 2% of its field
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.

NCT02563327 phase3completednot on this mapstarted 2016, after this paper: background citation

TBTC Study 31 PK/PD: Population Pharmacokinetic and Pharmacodynamic Study of Efficacy and Safety of High-Dose Rifapentine and Moxifloxacin for Treatment of Tuberculosis in the Study 31 Treatment Trial: Intensive PK Sampling

TypeinterventionalSponsorCenters for Disease Control and PreventionRan2016 to 2021Enrolled2,516ConditionsTuberculosisArmsRifapentine, Moxifloxacin, Rifampin, Isoniazid, Pyrazinamide
NCT07018076 recruitingnot on this mapstarted 2025, after this paper: background citation

Candidate Clinical Correlate of Prognostic Outcome for TB Study

TypeobservationalSponsorUniversity of California, San FranciscoRan2025 to 2027Enrolled750ConditionsTuberculosisArmsRS ratio, Blood-based host immune response assays
3 · Its place in the literature

Who cites it

139 citing papers in PubMed, 7 syntheses or guidelines pooled it, 258 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. A systematic review and meta-analysis of first-line tuberculosis drug concentrations and treatment outcomes.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2020
    Pooled it
  4. Guideline
  5. Pooled it
  6. Guideline
  7. Pooled it
  8. Trial
  9. Trial
  10. Trial
  11. Trial
  12. Trial
  13. Trial
  14. Trial
  15. Trial
  16. Article
  17. Article
  18. Future Prospects for Using Clinical Phenotypes in Tuberculosis Precision Medicine-An Approach for Clinical Management.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026
    Review
  19. Article
  20. Beyond culturability: VBNC-like and differentially culturableFrontiers in cellular and infection microbiology · 2026
    Review

79 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 1 country.

David J HorneDivision of Pulmonary and Critical Care Medicine, Seattle, WA 98104, USA. dhorne@u.washington.edu <dhorne@u.washington.edu>
Sarah E Royce
Lisa Gooze
Masahiro Narita
Philip C Hopewell
Payam Nahid
Karen R Steingart
University of California, San Francisco · USDeutsches Historisches Institut Washington · USSan Mateo County Health System · USUniversity of Washington · US

Funding

Tuberculosis Infection and Genetic VariationK23AI085036 · NIAID · UNIVERSITY OF WASHINGTON · PI HORNE, DAVID J. · 2010 to 2014
$638k
Predictors of short-term and long-term outcome after a diagnosis of tuberculosisF32HL094031 · NHLBI · UNIVERSITY OF WASHINGTON · PI HORNE, DAVID J. · 2008 to 2009
$109k
NHLBI NIH HHS F32 HL094031NIAID NIH HHS K23 AI085036NIAID NIH HHS L30 AI079849
6 · The paper itself

Abstract

WHO has previously recommended sputum-smear examination at the end of the second month of treatment in patients with recently diagnosed pulmonary tuberculosis, and, if positive, extension of the intensive therapy phase. We did a systematic review and meta-analysis to assess the accuracy of a positive sputum smear or culture during treatment for predicting failure or relapse in pulmonary tuberculosis. We searched PubMed, Embase, and the Cochrane Library for studies published in English through December, 2009. We included randomised controlled trials, cohort, and case-control studies of previously untreated pulmonary tuberculosis patients who had received a standardised regimen with rifampicin in the initial phase. Accuracy results were summarised in forest plots and pooled by use of a hierarchical regression approach. 15 papers (28 studies) met the inclusion criteria. The pooled sensitivities for both 2-month smear (24% [95% CI 12-42%], six studies) and culture (40% [95% CI 25-56%], four studies) to predict relapse were low. Corresponding specificities (85% [95% CI 72-90%] and 85% [95% CI 77-91%]) were higher, but modest. For failure, 2-month smear (seven studies) had low sensitivity (57% [95% CI 41-73%]) and higher, although modest, specificity (81% [95% CI 72-87%]). Both sputum-smear microscopy and mycobacterial culture during tuberculosis treatment have low sensitivity and modest specificity for predicting failure and relapse. Although we pooled a diverse group of patients, the individual studies had similar performance characteristics. Better predictive markers are needed.

Indexed as

Bacteriological TechniquesDrug MonitoringHumansMicroscopyMycobacterium tuberculosisPredictive Value of TestsPrognosisRecurrenceSensitivity and SpecificitySputumTreatment FailureTuberculosis

Identifiers

PMID20510279
PMCPMC3046810
OpenAlexW2099498194

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

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.