Evidence map›Paper›PMID 30717738›Full record

Observational studyBMC public health2019

Diagnostic pathways and delay among tuberculosis patients in Stockholm, Sweden: a retrospective observational study.

Anna Wikell, Helena Åberg, Jad Shedrawy, Isac Röhl, Jerker Jonsson, Ingela Berggren, Charlotte Buxbaum, Knut Lönnroth, Judith Bruchfeld

Open access · goldAbstract readObservational Study
In one paragraph

Observational study in BMC public health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.6field-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, 6 citations in OpenAlex.

  1. Trial
  2. Article
  3. Article
  4. 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

9 authors at 4 institutions in 1 country.

Anna WikellDivision of Infectious Diseases, Department of Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden. annamwikell@gmail.com.ORCID http://orcid.org/0000-0002-4141-0247
Helena ÅbergDivision of Infectious Diseases, Department of Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden.
Jad ShedrawyDepartment of Public Health Sciences, Karolinska Institutet, 171 77, Stockholm, Sweden.
Isac RöhlDivision of Infectious Diseases, Department of Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden.
Jerker JonssonDivision of Infectious Diseases, Department of Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden.
Ingela BerggrenDepartment of Communicable Disease Control & Prevention, Stockholm County Council, 118 91, Stockholm, Sweden.
Charlotte BuxbaumDepartment of Pediatrics, Karolinska University Hospital Huddinge, 141 86, Stockholm, Sweden.
Knut LönnrothDepartment of Public Health Sciences, Karolinska Institutet, 171 77, Stockholm, Sweden.
Judith BruchfeldDivision of Infectious Diseases, Department of Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden.
Karolinska Institutet · SEKarolinska University Hospital · SEStockholm County Council · SEPublic Health Agency of Sweden · SE

Funding

Forskningsrådet om Hälsa, Arbetsliv och Välfärd 2015-00304Hjärt-Lungfonden 20160508
6 · The paper itself

Abstract

backgroundAsylum seekers in Sweden are offered tuberculosis (TB) screening at a voluntary post-arrival health examination. The role of this screening in improving the TB diagnostic pathway has not been previously evaluated. The aim of this study was to determine diagnostic pathways for active TB cases and compare diagnostic delays between different pathways.

methodsRetrospective review of medical records of patients reported with active TB in Stockholm in 2015, using a structured and pre-coded form.

resultsSeventy-one percent of patients actively sought health care due to symptoms. As for source of referral to TB specialist clinic, 15% came from screening of eligible migrants, of whom the majority were asymptomatic. Among asylum seekers, 69% were identified through screening at a health examination (HE). The main sources of referral to TB clinics were emergency departments (27%) and primary health care centers (20%). Median health care provider delay was significantly longer in patients identified through migrant screening in health examination.

conclusionsScreening at a health examination was the main pathway of active TB detection among mainly asymptomatic and non-contagious asylum seekers but contributed modestly to total overall TB case detection. In these patients TB was diagnosed early in a non-contagious phase of the disease. Further research is required to assess the effectiveness and cost-effectiveness of HE TB screening as well as inclusion of other groups of migrants from high incidence countries in the screening program in terms of impact on delay, transmission and treatment outcomes.

Indexed as

RefugeesAdolescentAdultAgedAged, 80 and overChildChild, PreschoolDelayed DiagnosisFemaleHumansInfantInfant, NewbornMaleMass ScreeningMedical RecordsMiddle AgedAsylum seekersDiagnostic delayHealth examinationScreeningTuberculosis

Identifiers

PMID30717738
PMCPMC6360687
OpenAlexW2921958512

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.