Evidence map›Paper›PMID 30125689›Full record

ArticleInternational journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases2018

Incremental yield and cost of urine Determine TB-LAM and sputum induction in seriously ill adults with HIV.

Tom H Boyles, Rulan Griesel, Annemie Stewart, Marc Mendelson, Gary Maartens

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 4 pooled it
2.6field-weighted citation impact, top 10% 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

22 citing papers in PubMed, 4 syntheses or guidelines pooled it, 31 citations in OpenAlex.

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  11. Cost-effectiveness of a Novel Lipoarabinomannan Test for Tuberculosis in Patients With Human Immunodeficiency Virus.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021
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  15. Etiology of Pulmonary Infections in Human Immunodeficiency Virus-infected Inpatients Using Sputum Multiplex Real-time Polymerase Chain Reaction.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020
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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

5 authors at 1 institution in 1 country.

Tom H BoylesDivision of Infectious Diseases and HIV Medicine, Department of Medicine, University of Cape Town, Cape Town, South Africa. Electronic address: tomboyles@yahoo.com.
Rulan GrieselDivision of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa.
Annemie StewartDivision of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa.
Marc MendelsonDivision of Infectious Diseases and HIV Medicine, Department of Medicine, University of Cape Town, Cape Town, South Africa.
Gary MaartensDivision of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa.
University of Cape Town · ZA

Funding

An evidence based algorithm for diagnosis of tuberculosis in HIV patientsR01AI096735 · NIAID · UNIVERSITY OF CAPE TOWN · PI MAARTENS, GARY, MENDELSON, MARC · 2011 to 2014
$369k
NIAID NIH HHS R01 AI096735
6 · The paper itself

Abstract

backgroundTuberculosis is a major cause of mortality among HIV-infected inpatients, and the World Health Organization (WHO) recommends an algorithm to improve diagnosis. The urine lateral flow lipoarabinomannan (LAM) and sputum Xpert MTB/RIF tests are promising tools, but the optimal diagnostic algorithm is unclear.

methodsThis prospective cohort study enrolled HIV-positive inpatients with cough and WHO danger signs. The Xpert MTB/RIF test and mycobacterial culture were performed on sputum using sputum induction when necessary, and the LAM test was performed on stored urine. Tuberculosis was diagnosed by culture from any site. The diagnostic accuracy and costs of testing were determined for single and combined tests.

resultsTuberculosis was confirmed in 169 of 332 patients (50.9%). The yield of LAM, Xpert MTB/RIF on spontaneous sputum (Xpert Spot), and Xpert MTB/RIF on spontaneous or induced sputum (Xpert SI) was 35.5%, 23.1%, and 90.5%, respectively. When LAM was placed before Xpert Spot and Xpert SI in an algorithm, the yield was 50.9% and 92.3%, respectively. Adding culture to Xpert MTB/RIF only increased the yield by 1.2% and 2.7%, respectively. Use of the LAM test reduced costs.

conclusionsSputum induction is important to increase the yield of Xpert MTB/RIF for seriously ill patients with HIV and cough. LAM testing has little effect on yield when sputum induction is available, but reduces costs and may have other benefits.

Indexed as

AdultAlgorithmsDiagnostic Techniques and ProceduresFemaleHIV InfectionsHumansLipopolysaccharidesMaleMiddle AgedMycobacterium tuberculosisProspective StudiesSputumTuberculosislipoarabinomannanLipopolysaccharidesDiagnosisLAMSputum inductionTuberculosisXpert MTB/RIF

Identifiers

PMID30125689
PMCPMC6202059
OpenAlexW2885819281

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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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.