ArticleBMC infectious diseases2014
Choosing algorithms for TB screening: a modelling study to compare yield, predictive value and diagnostic burden.
Article 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 48 papers, 5 of them syntheses that pooled it.
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Who cites it
48 citing papers in PubMed, 5 syntheses or guidelines pooled it, 67 citations in OpenAlex.
- How to diagnose TB in migrants? A systematic review of reviews and decision tree analytical modelling exercise to evaluate properties for single and combined tuberculosis screening tests.The European respiratory journal · 2025Pooled it
- Symptom- and chest-radiography screening for active pulmonary tuberculosis in HIV-negative adults and adults with unknown HIV status.The Cochrane database of systematic reviews · 2022Pooled it
- Diagnostic accuracy of C-reactive protein for active pulmonary tuberculosis: a meta-analysis.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2017Pooled it
- Pooled it
- Comparative meta-analysis of tuberculosis contact investigation interventions in eleven high burden countries.PloS one · 2015Pooled it
- Effect of patient-delivered household contact tracing and prevention for tuberculosis: A household cluster-randomised trial in Malawi.PloS one · 2022Trial
- A public-private partnership for facility-based tuberculosis screening using chest radiographs, Viet Nam.Bulletin of the World Health Organization · 2026Article
- 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
- Evaluation of Queue Management System (QMS) Use in Chest X-Ray for Tuberculosis Screening: A Case Study.The Indian journal of radiology & imaging · 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
- Performance of Computer-Aided Detection Software in Tuberculosis Case Finding in Township Health Centers in China.Chronic diseases and translational medicine · 2025Article
- Cost-effectiveness analysis of a prediction model for community-based screening of active tuberculosis.Journal of global health · 2024Article
- Predictors contributing to the estimation of pulmonary tuberculosis among adults in a resource-limited setting: A systematic review of diagnostic predictions.SAGE open medicine · 2024Review
- Improving TB control: efficiencies of case-finding interventions in Nigeria.Public health action · 2023Article
- Incidental radiological findings during clinical tuberculosis screening in Lesotho and South Africa: a case series.Journal of medical case reports · 2023Article
- Pre-treatment chest X-ray stability duration and tuberculosis disease in San Diego, California, 2012-2017.Journal of clinical tuberculosis and other mycobacterial diseases · 2022Article
- Use of chest radiography screening for TB: a re-evaluation of the Kolín study.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2022Article
- Country differences and determinants of yield in programmatic migrant TB screening in four European countries.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2022Article
- Comparison of yield and relative costs of different screening algorithms for tuberculosis in active case-finding: a cross-section study.BMC infectious diseases · 2021Article
- 'If not TB, what could it be?' Chest X-ray findings from the 2016 Kenya Tuberculosis Prevalence Survey.Thorax · 2021Article
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundTo inform the choice of an appropriate screening and diagnostic algorithm for tuberculosis (TB) screening initiatives in different epidemiological settings, we compare algorithms composed of currently available methods.
methodsOf twelve algorithms composed of screening for symptoms (prolonged cough or any TB symptom) and/or chest radiography abnormalities, and either sputum-smear microscopy (SSM) or Xpert MTB/RIF (XP) as confirmatory test we model algorithm outcomes and summarize the yield, number needed to screen (NNS) and positive predictive value (PPV) for different levels of TB prevalence.
resultsScreening for prolonged cough has low yield, 22% if confirmatory testing is by SSM and 32% if XP, and a high NNS, exceeding 1000 if TB prevalence is ≤0.5%. Due to low specificity the PPV of screening for any TB symptom followed by SSM is less than 50%, even if TB prevalence is 2%. CXR screening for TB abnormalities followed by XP has the highest case detection (87%) and lowest NNS, but is resource intensive. CXR as a second screen for symptom screen positives improves efficiency.
conclusionsThe ideal algorithm does not exist. The choice will be setting specific, for which this study provides guidance. Generally an algorithm composed of CXR screening followed by confirmatory testing with XP can achieve the lowest NNS and highest PPV, and is the least amenable to setting-specific variation. However resource requirements for tests and equipment may be prohibitive in some settings and a reason to opt for symptom screening and SSM. To better inform disease control programs we need empirical data to confirm the modeled yield, cost-effectiveness studies, transmission models and a better screening test.
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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.