ArticleScientific reports2016
Serial testing for latent tuberculosis using QuantiFERON-TB Gold In-Tube: A Markov model.
Article in Scientific reports, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 46 citations in OpenAlex.
- Risk of latent and active tuberculosis infection in travellers: a systematic review and meta-analysis.Journal of travel medicine · 2021Pooled it
- Brazilian guidelines for the management of tuberculosis infection in immune-mediated inflammatory diseases: is retesting in latent tuberculosis screening appropriate and Safe?Advances in rheumatology (London, England) · 2025Article
- Capturing RecentTropical medicine and infectious disease · 2024Article
- Serially Combining Epidemiological Designs Does Not Improve Overall Signal Detection in Vaccine Safety Surveillance.Drug safety · 2023Article
- Enhancing the interferon-γ release assay through omission of nil and mitogen values.Respiratory research · 2023Article
- Alternative biomarkers of tuberculosis infection in patients with immune-mediated inflammatory diseases.Frontiers in medicine · 2023Article
- Article
- Article
- Conversion and Reversion Rates of Tuberculosis Screening Assays in Patients With Rheumatic Diseases and Negative Baseline Screening Under Long-Term Biologic Treatment.Pathogens & immunity · 2020Article
- Comparison of QFT-Plus and QFT-GIT tests for diagnosis ofJournal of thoracic disease · 2019Article
- Conversion of Tuberculosis Screening Tests During Biologic Therapy Among Veteran Patient Population With Rheumatic Disease.ACR open rheumatology · 2019Article
- A Feasibility Study for Diagnosis of Latent Tuberculosis Infection Using an IGRA Point-of-Care Platform in South Korea.Yonsei medical journal · 2019Article
- Paradox of serial interferon-gamma release assays: variability width more important than specificity size.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2018Article
- A scoring strategy for progression risk and rates of treatment completion in subjects with latent tuberculosis.PloS one · 2018Article
- Optimization and Interpretation of Serial QuantiFERON Testing to Measure Acquisition of Mycobacterium tuberculosis Infection.American journal of respiratory and critical care medicine · 2017Article
- Revisiting annual screening for latent tuberculosis infection in healthcare workers: a cost-effectiveness analysis.BMC medicine · 2017Article
- A borderline range for Quantiferon Gold In-Tube results.PloS one · 2017Article
- Clinical Application of Interferon-γ Release Assays for the Prevention of Tuberculosis in Countries with Low Incidence.Pathogens & immunity · 2016Article
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 4 countries.
Funding
Abstract
Healthcare workers (HCWs) in low-incidence settings are often serially tested for latent TB infection (LTBI) with the QuantiFERON-TB Gold In-Tube (QFT) assay, which exhibits frequent conversions and reversions. The clinical impact of such variability on serial testing remains unknown. We used a microsimulation Markov model that accounts for major sources of variability to project diagnostic outcomes in a simulated North American HCW cohort. Serial testing using a single QFT with the recommended conversion cutoff (IFN-g > 0.35 IU/mL) resulted in 24.6% (95% uncertainty range, UR: 23.8-25.5) of the entire population testing false-positive over ten years. Raising the cutoff to >1.0 IU/mL or confirming initial positive results with a (presumed independent) second test reduced this false-positive percentage to 2.3% (95%UR: 2.0-2.6%) or 4.1% (95%UR: 3.7-4.5%), but also reduced the proportion of true incident infections detected within the first year of infection from 76.5% (95%UR: 66.3-84.6%) to 54.8% (95%UR: 44.6-64.5%) or 61.5% (95%UR: 51.6-70.9%), respectively. Serial QFT testing of HCWs in North America may result in tremendous over-diagnosis and over-treatment of LTBI, with nearly thirty false-positives for every true infection diagnosed. Using higher cutoffs for conversion or confirmatory tests (for initial positives) can mitigate these effects, but will also diagnose fewer true infections.
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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.