ArticleThe international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease2015
The patient impact of point-of-care vs. laboratory placement of Xpert(®) MTB/RIF.
Article in The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03187964 (Feasibility, Accuracy, and Effect of Polyvalent Point-of-care Xpert MTB/RIF Ultra and Xpert HIV-1 Viral Load Testing in HIV-positive Patients Initiating ART), which is not on this map. Cited by 23 papers, 2 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.
Feasibility, Accuracy, and Effect of Polyvalent Point-of-care Xpert MTB/RIF Ultra and Xpert HIV-1 Viral Load Testing in HIV-positive Patients Initiating ART: a Randomised Controlled Trial
Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- High HIV and active tuberculosis prevalence and increased mortality risk in adults with symptoms of TB: a systematic review and meta-analyses.Journal of the International AIDS Society · 2018Pooled it
- TB as a cause of hospitalization and in-hospital mortality among people living with HIV worldwide: a systematic review and meta-analysis.Journal of the International AIDS Society · 2016Pooled it
- Impact of Point-of-Care Xpert MTB/RIF on Tuberculosis Treatment Initiation. A Cluster-randomized Trial.American journal of respiratory and critical care medicine · 2017Trial
- Factors associated with tuberculosis treatment initiation among bacteriologically negative individuals evaluated for tuberculosis: an individual patient data meta-analysis.medRxiv : the preprint server for health sciences · 2024Article
- Article
- Rapid Molecular Assays for the Diagnosis of Drug-Resistant Tuberculosis.Infection and drug resistance · 2022Review
- Article
- Performance of XpertPublic health action · 2020Article
- Performance of the Roche cobas MTB Assay for the Molecular Diagnosis of Pulmonary Tuberculosis in a High HIV Burden Setting.The Journal of molecular diagnostics : JMD · 2020Article
- Impact of External Quality Assurance on the Quality of Xpert MTB/RIF Testing in Viet Nam.Journal of clinical microbiology · 2019Article
- Rapid, point-of-care diagnosis of tuberculosis with novel Truenat assay: Cost-effectiveness analysis for India's public sector.PloS one · 2019Article
- C-reactive protein as a screening test for HIV-associated pulmonary tuberculosis prior to antiretroviral therapy in South Africa.AIDS (London, England) · 2018Article
- Impact of involvement of non-formal health providers on TB case notification among migrant slum-dwelling populations in Odisha, India.PloS one · 2018Article
- Estimated clinical impact of the Xpert MTB/RIF Ultra cartridge for diagnosis of pulmonary tuberculosis: A modeling study.PLoS medicine · 2017Article
- The South African Tuberculosis Care Cascade: Estimated Losses and Methodological Challenges.The Journal of infectious diseases · 2017Article
- Rolling Out XpertAfrican journal of laboratory medicine · 2017Article
- Diagnosis of opportunistic infections: HIV co-infections - tuberculosis.Current opinion in HIV and AIDS · 2017Review
- Performance of XpertAfrican journal of laboratory medicine · 2017Article
- Observational
- Impact of the GeneXpert MTB/RIF Technology on Tuberculosis Control.Microbiology spectrum · 2017Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
backgroundThe Xpert(®) MTB/RIF assay can diagnose tuberculosis (TB) rapidly and with great accuracy. The effect of Xpert placement at point of care (POC) vs. at an off-site laboratory on patient management remains unknown.
designAt a primary care clinic in Johannesburg, South Africa, we compared TB diagnosis and treatment initiation among 1861 individuals evaluated for pulmonary TB using Xpert performed either at POC or offsite.
resultsWhen Xpert was performed at POC, a higher proportion of Xpert-positive individuals started treatment (95% vs. 87%, P = 0.047) and time to treatment initiation was shorter (median 0 vs. 5 days, P < 0.001). In contrast, among Xpert-negative TB cases, a higher proportion (87% vs. 72%, P = 0.001) started treatment when the sample was sent to the laboratory, with a shorter time to treatment (median 9 vs. 13 days, P = 0.056). While the overall proportion of presumed TB patients starting treatment was independent of Xpert placement, the proportion started based on a bacteriologically confirmed diagnosis was higher when Xpert was performed at POC (73% vs. 58%, P = 0.006).
conclusionsPlacement of Xpert at POC resulted in more Xpert-positive patients receiving treatment, but did not increase the total number of presumed TB patients starting treatment. When samples were sent to a laboratory for Xpert testing, empiric decision making increased.
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Registered trials
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