ArticleAmerican journal of respiratory and critical care medicine2013
Is passive diagnosis enough? The impact of subclinical disease on diagnostic strategies for tuberculosis.
Article in American journal of respiratory and critical care medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03044158 (GeneXpert Performance Evaluation for Linkage to Tuberculosis Care), which is not on this map. Cited by 80 papers, 5 of them syntheses that pooled 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.
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.
GeneXpert Performance Evaluation for Linkage to Tuberculosis Care: The XPEL-TB Trial
Who cites it
80 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Systematic Review of Pooling Sputum as an Efficient Method for Xpert MTB/RIF Tuberculosis Testing during the COVID-19 Pandemic.Emerging infectious diseases · 2021Pooled it
- Preventing the spread of multidrug-resistant tuberculosis and protecting contacts of infectious cases.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2017Pooled it
- Sex Differences in Tuberculosis Burden and Notifications in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis.PLoS medicine · 2016Pooled it
- Delays in diagnosis and treatment of pulmonary tuberculosis in India: a systematic review.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2014Pooled it
- Modeling of novel diagnostic strategies for active tuberculosis - a systematic review: current practices and recommendations.PloS one · 2014Pooled it
- Household Contact Tracing With Intensified Tuberculosis and Human Immunodeficiency Virus Screening in South Africa: A Cluster-Randomized Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Trial
- Biomarker-guided tuberculosis preventive therapy (CORTIS): a randomised controlled trial.The Lancet. Infectious diseases · 2021Trial
- Comparison of phylogenetic metrics of transmission between symptomatic and asymptomatic tuberculosis in individuals who were incarcerated in Brazil in 2008-24: a retrospective genomic epidemiology study.The Lancet. Microbe · 2026Article
- Unexpected detection of Mycobacterium tuberculosis DNA in US-born patients in putative association with clinical syndromes.Nature communications · 2026Observational
- Refining research outcomes: Lessons from the setup of an endpoint review committee and radiological review in tuberculosis observational diagnostic studies.PLOS global public health · 2026Article
- Screening of close contacts of pulmonary tuberculosis in an urban area in Shanghai, China: a cross-sectional study.BMC infectious diseases · 2025Article
- Projecting the Impact and Costs of Near Point-of-Care Tuberculosis Screening Assays in Community-based Active Case Finding.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Article
- The health impact of identifying a person with tuberculosis through systematic screening.The Lancet. Infectious diseases · 2025Review
- Importance of confirmatory test characteristics in optimizing community-based screening for tuberculosis: an epidemiological modeling analysis.BMC infectious diseases · 2025Article
- Comparison of phylogenetic metrics of transmission in symptomatic and asymptomatic tuberculosis.medRxiv : the preprint server for health sciences · 2025Article
- Implementation costs and cost-effectiveness of ultraportable chest X-ray with artificial intelligence in active case finding for tuberculosis in Nigeria.PLOS digital health · 2025Article
- Potential impact, costs, and benefits of population-wide screening interventions for tuberculosis in Viet Nam: A mathematical modelling study.PLOS global public health · 2025Article
- Clinical features of Tibetan adolescent tuberculosis at high altitudes: a retrospective study.BMC pulmonary medicine · 2024Article
- Community-Wide Active Case Finding for Tuberculosis: Time to Use the Evidence We Have.Tropical medicine and infectious disease · 2024Review
- One Half of the Pair: Prioritizing Tuberculosis Transmitters for Early Detection.American journal of respiratory and critical care medicine · 2024Article
20 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
Abstract
rationaleTuberculosis (TB) is characterized by a subclinical phase (symptoms absent or not considered abnormal); prediagnostic phase (symptoms noticed but diagnosis not pursued); and clinical phase (care actively sought). Diagnostic capacity during these phases is limited.
objectivesTo estimate the population-level impact of TB case-finding strategies in the presence of subclinical and prediagnostic disease.
methodsWe created a mathematical epidemic model of TB, calibrated to global incidence. We then introduced three prototypical diagnostic interventions: increased sensitivity of diagnosis in the clinical phase by 20% ("passive"); early diagnosis during the prediagnostic phase at a rate of 10% per year ("enhanced"); and population-based diagnosis of 5% of undiagnosed prevalent cases per year ("active"). MEASUREMENTS AND MAIN
resultsIf the subclinical phase was ignored, as in most models, the passive strategy was projected to reduce TB incidence by 18% (90% uncertainty range [UR], 11-32%) by year 10, compared with 23% (90% UR, 14-35%) for the enhanced strategy and 18% (90% UR, 11-28%) for the active strategy. After incorporating a subclinical phase into the model, consistent with population-based prevalence surveys, the active strategy still reduced 10-year TB incidence by 16% (90% UR, 11-28%), but the passive and enhanced strategies' impact was attenuated to 11% (90% UR, 8-25%) and 6% (90% UR, 4-13%), respectively. The degree of attenuation depended strongly on the transmission rate during the subclinical phase.
conclusionsSubclinical disease may limit the impact of current diagnostic strategies for TB. Active detection of undiagnosed prevalent cases may achieve greater population-level TB control than increasing passive case detection.
Indexed as
Identifiers
What OpenQuestion holds
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.