Evidence map›Paper›PMID 24552306›Full record

Trial reportBMC infectious diseases2014

A randomized controlled trial of standard versus intensified tuberculosis diagnostics on treatment decisions by physicians in Northern Tanzania.

Elizabeth A Reddy, Boniface N Njau, Susan C Morpeth, Kathryn E Lancaster, Alison C Tribble, Venance P Maro, Levina J Msuya, Anne B Morrissey, Gibson S Kibiki, Nathan M Thielman and 8 more

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMC infectious diseases, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
0.5field-weighted citation impact, top 34% 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.

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

4 citing papers in PubMed, 2 syntheses or guidelines pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Mycobacterium tuberculosis: 2014 Clinical trials in review.The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale
    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

18 authors at 7 institutions in 3 countries.

Elizabeth A ReddyDuke University Medical Center, Durham, NC, USA. elizabeth.reddy@duke.edu.
Boniface N Njau
Susan C Morpeth
Kathryn E Lancaster
Alison C Tribble
Venance P Maro
Levina J Msuya
Anne B Morrissey
Gibson S Kibiki
Nathan M Thielman
Coleen K Cunningham
Werner Schimana
John F Shao
Shein-Chung Chow
Jason E Stout
John A Crump
John A Bartlett
Carol D Hamilton
Kilimanjaro Christian Medical Centre · TZDuke Medical Center · USDuke University · USChildren's Hospital of Philadelphia · USElizabeth Glaser Pediatric AIDS Foundation · TZKenya Medical Research Institute · KEUniversity of North Carolina at Chapel Hill · US

Funding

Social and Behavioral Sciences CoreP30AI064518 · NIAID · DUKE UNIVERSITY · PI Nwora Lance Okeke · 2005 to 2026
$50.5M
Ruth L. Kirschstein National Research Service Award (NRSA)- T32T32AI007392 · NIAID · DUKE UNIVERSITY · PI Amy Lynn Corneli, Guido Ferrari · 1990 to 2026
$9.8M
International Clinical Trials UnitU01AI062563 · NIAID · DUKE UNIVERSITY · PI BARTLETT, JOHN A · 2004 to 2007
$4.0M
NIAID NIH HHS P30 AI 64518NIAID NIH HHS T32 AI007392-18NIAID NIH HHS U01 AI062563
6 · The paper itself

Abstract

backgroundRoutine tuberculosis culture remains unavailable in many high-burden areas, including Tanzania. This study sought to determine the impact of providing mycobacterial culture results over standard of care [unconcentrated acid-fast (AFB) smears] on management of persons with suspected tuberculosis.

methodsAdults and children with suspected tuberculosis were randomized to standard (direct AFB smear only) or intensified (concentrated AFB smear and tuberculosis culture) diagnostics and followed for 8 weeks. The primary endpoint was appropriate treatment (i.e. antituberculosis therapy for those with tuberculosis, no antituberculous therapy for those without tuberculosis).

resultsSeventy participants were randomized to standard (n = 37, 53%) or intensive (n = 33, 47%) diagnostics. At 8 weeks, 100% (n = 22) of participants in follow up randomized to intensive diagnostics were receiving appropriate care, vs. 22 (88%) of 25 participants randomized to standard diagnostics (p = 0.14). Overall, 18 (26%) participants died; antituberculosis therapy was associated with lower mortality (9% who received antiuberculosis treatment died vs. 26% who did not, p = 0.04).

conclusionsUnder field conditions in a high burden setting, the impact of intensified diagnostics was blunted by high early mortality. Enhanced availability of rapid diagnostics must be linked to earlier access to care for outcomes to improve.

Indexed as

Bacteriological TechniquesDiagnostic Tests, RoutineAdultAntitubercular AgentsChild, PreschoolDecision MakingFemaleHIV InfectionsHumansInfantMaleMiddle AgedMycobacterium tuberculosisStandard of CareTanzaniaTreatment OutcomeAntitubercular Agents

Identifiers

PMID24552306
PMCPMC3974106
OpenAlexW2041833545

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.