ArticleBMC public health2019
Sensitivity and specificity of routine diagnostic work-up for tuberculosis in lung clinics in Yogyakarta, Indonesia: a cohort study.
Article in BMC public health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02219945 (The Accuracy of the eNose in the Diagnostics and Monitoring of Treatment of Treatment-naive TB Patients), which is not on this map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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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.
The Accuracy of the eNose in the Diagnostics and Monitoring of Treatment of Treatment-naive TB Patients
Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Diagnosis of tuberculosis through breath test: A systematic review.EBioMedicine · 2019Pooled it
- Activation and proliferation profiles of M.tuberculosis specific dual functional CD4+T cells from smear negative pulmonary TB patients.PloS one · 2025Article
- A Call to Action: Empowering Pharmacists in Drug-Resistant Tuberculosis Management.Journal of multidisciplinary healthcare · 2025Review
- Diagnostic Dilemma: Investigating Respiratory Symptoms in a Middle-Aged Smoker.Clinical case reports · 2024Article
- Infectious causes of fever of unknown origin in developing countries: An international ID-IRI study.Journal of intensive medicine · 2024Article
- Early detection of tuberculosis in patients with smear-negative pulmonary tuberculosis.The Korean journal of internal medicine · 2022Article
- Mycobacterium tuberculosis antigen-specific T-cell responses in smear-negative pulmonary tuberculosis patients.Clinical and experimental immunology · 2022Article
- Persistent expression of activation markers on Mycobacterium tuberculosis-specific CD4 T cells in smear negative TB patients.PloS one · 2022Article
- Barriers to Optimal Tuberculosis Treatment Services at Community Health Centers: A Qualitative Study From a High Prevalent Tuberculosis Country.Frontiers in pharmacology · 2022Article
- Diagnosing Tuberculosis: What Do New Technologies Allow Us to (Not) Do?Respiration; international review of thoracic diseases · 2022Review
- Applications of artificial intelligence in the thorax: a narrative review focusing on thoracic radiology.Journal of thoracic disease · 2021Review
- The effect of empirical and laboratory-confirmed tuberculosis on treatment outcomes.Scientific reports · 2021Article
- Tuberculosis diagnostics: overcoming ancient challenges with modern solutions.Emerging topics in life sciences · 2020Review
- Sensitivity and specificity of an electronic nose in diagnosing pulmonary tuberculosis among patients with suspected tuberculosis.PloS one · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundEstablishing a correct diagnosis is challenging. We aimed to investigate the sensitivity and specificity of routine tuberculosis (TB) diagnostic work-up in lung clinics in Indonesia, a country with the third highest TB burden and the second highest gap between notifications of TB cases and the best estimate of incident cases in the world.
methodsIn the lung clinics of the Province of Yogyakarta, Indonesia, we recruited all consecutive patients with symptoms suggesting TB, aged ≥18 years. Routine TB examination consisted of clinical evaluation, sputum smear microscopy, and chest radiography. For research purposes, we added sputum culture, Human Immunodeficiency Virus (HIV) testing, and follow-up for 1.5 years or 2.5 years if culture results disagreed with the initial clinical diagnosis. The initial diagnosis was considered incorrect if patients did not respond to treatment. We calculated sensitivity and specificity of the TB routine examination using culture and a composite reference standard (CRS - a combination of routine examination, culture, and follow-up) as the reference standards. All analyses were conducted with IBM SPSS Statistics 25 (IBM Corp., Armonk, NY, USA).
resultsBetween 2013 and 2015, we included 360 participants, and 21 were excluded due to incomplete data. Among those analyzed, 115 were initially diagnosed with smear-positive TB, 12 with smear-negative TB, and 212 non-TB. In 15 study participants, the diagnosis was changed after median 45 (range: 14-870) days; 14 participants initially not diagnosed with TB were later diagnosed with TB, while one subject initially diagnosed with TB actually did not have TB. Compared with culture and CRS, TB routine examination had sensitivity of 85% (95%CI: 77-91) and 90% (95%CI: 84-94), and specificity of 86.3% (95%CI: 81-91) and 99.5% (95%CI: 97-100), respectively.
conclusionsA combination of clinical evaluation with sputum microscopy and chest radiography provided high sensitivity and specificity in diagnosing TB in lung clinics; in only 4.4% the diagnosis was incorrect. There is a need to improve routine TB diagnostic work by using clinical evaluation, sputum smear microscopy, and chest radiography all together in other settings, such as in primary health centers.
trial registrationNCT02219945 , clinicaltrials.gov . Registered 19 August 2014 (retrospectively registered).
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