ArticleThorax2013
Incremental value of T-SPOT.TB for diagnosis of active pulmonary tuberculosis in children in a high-burden setting: a multivariable analysis.
Article in Thorax, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 5 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
16 citing papers in PubMed, 5 syntheses or guidelines pooled it, 31 citations in OpenAlex.
- Revolutionizing diagnosis of pulmonaryFrontiers in microbiology · 2024Pooled it
- Screening tests for active pulmonary tuberculosis in children.The Cochrane database of systematic reviews · 2021Pooled it
- Risk Factors for Indeterminate Interferon-Gamma Release Assay for the Diagnosis of Tuberculosis in Children-A Systematic Review and Meta-Analysis.Frontiers in pediatrics · 2019Pooled it
- Recommendations for the diagnosis of pediatric tuberculosis.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2016Guideline
- Systematic review and meta-analysis on the utility of Interferon-gamma release assays for the diagnosis of Mycobacterium tuberculosis infection in children: a 2013 update.BMC infectious diseases · 2014Pooled it
- Improving the diagnostic performance for prior COVID-19 with T-SPOT, an interferon-gamma release assay.Frontiers in microbiology · 2025Article
- Review and Updates on the Diagnosis of Tuberculosis.Journal of clinical medicine · 2022Review
- Active tuberculosis in patients with systemic lupus erythematosus from Southern China: a retrospective study.Clinical rheumatology · 2019Article
- Prospective Comparison of QFT-GIT and T-SPOT.TB Assays for Diagnosis of Active Tuberculosis.Scientific reports · 2018Article
- Factors associated with negative T-SPOT.TB results among smear-negative tuberculosis patients in China.Scientific reports · 2018Article
- Application Values of T-SPOT.TB in Clinical Rapid Diagnosis of Tuberculosis.Iranian journal of public health · 2018Article
- 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
- Epidemiology and clinical management of tuberculosis in children in Canada.Paediatrics & child health · 2015Review
- Article
- The performance and limitation of T-SPOT.TB for the diagnosis of TB in a high prevalence setting.Journal of thoracic disease · 2014Article
- Gamma interferon release assays for detection of Mycobacterium tuberculosis infection.Clinical microbiology reviews · 2014Review
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
Abstract
introductionInterferon γ release assays (IGRAs) are increasingly used for tuberculosis (TB) infection, but their incremental value beyond patient demographics, clinical signs and conventional tests for active disease has not been evaluated in children.
methodsThe incremental value of T-SPOT.TB was assessed in 491 smear-negative children from two hospitals in Cape Town, South Africa. Bayesian model averaging was used to select the optimal set of patient demographics and clinical signs for predicting culture-confirmed TB. The added value of T-SPOT.TB over and above patient characteristics and conventional tests was measured using statistics such as the difference in the area under the receiver operating characteristic curve (AUC), the net reclassification improvement (NRI) and the integrated discrimination improvement (IDI).
resultsCough longer than 2 weeks, fever longer than 2 weeks, night sweats, malaise, history of household contact and HIV status were the most important predictors of culture-confirmed TB. Binary T-SPOT.TB results did not have incremental value when added to the baseline model with clinical predictors, chest radiography and the tuberculin skin test. The AUC difference was 3% (95% CI 0% to 7%). Using risk cut-offs of <10%, 10-30% and >30%, the NRI was 7% (95% CI -8% to 31%) but the CI included the null value. The IDI was 3% (95% CI 0% to 11%), meaning that the average predicted probability across all possible cut-offs improved marginally by 3%.
conclusionsIn a high-burden setting, the T-SPOT.TB did not have added value beyond clinical data and conventional tests for diagnosis of TB disease in smear-negative children.
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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.