ArticlePloS one2020
Development of a risk score for prediction of poor treatment outcomes among patients with multidrug-resistant tuberculosis.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
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11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 12 citations in OpenAlex.
- Systematic review and meta-analysis of predictive accuracy of prognostic models for poor treatment outcome of drug resistance tuberculosis.Scientific reports · 2026Pooled it
- Pooled it
- New Strategies in Tuberculosis Prediction: TB-CAST, an Explainable Baseline Score for Two-Month Sputum Culture Positivity.Life (Basel, Switzerland) · 2026Article
- Development and validation of a LASSO-derived nomogram for predicting unfavorable treatment outcomes in drug-resistant pulmonary tuberculosis.BMC infectious diseases · 2026Article
- Using Machine Learning Methods to Predict Early Treatment Outcomes for Multidrug-Resistant or Rifampicin-Resistant Tuberculosis to Enhance Patient Cure Rates: Development and Validation of Multiple Models.Journal of medical Internet research · 2025Article
- Development and validation of a prediction model for unsuccessful treatment outcomes in patients with multi-drug resistance tuberculosis.BMC infectious diseases · 2023Article
- Prognostication of treatment non-compliance among patients with multidrug-resistant tuberculosis in the course of their follow-up: a logistic regression-based machine learning algorithm.Frontiers in digital health · 2023Article
- Tuberculosis Treatment Monitoring and Outcome Measures: New Interest and New Strategies.Clinical microbiology reviews · 2022Review
- A Score to Predict the Risk of Major Adverse Drug Reactions Among Multi-Drug Resistant Tuberculosis Patients in Southern Ethiopia, 2014-2019.Infection and drug resistance · 2022Article
- Treatment outcomes of drug resistant tuberculosis patients with multiple poor prognostic indicators in Uganda: A countrywide 5-year retrospective study.Journal of clinical tuberculosis and other mycobacterial diseases · 2021Article
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Authors and funding
6 authors at 4 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTreatment outcomes among patients treated for multidrug-resistant tuberculosis (MDR-TB) are often sub-optimal. Therefore, the early prediction of poor treatment outcomes may be useful in patient care, especially for clinicians when they have the ability to make treatment decisions or offer counselling or additional support to patients. The aim of this study was to develop a simple clinical risk score to predict poor treatment outcomes in patients with MDR-TB, using routinely collected data from two large countries in geographically distinct regions.
methodsWe used MDR-TB data collected from Hunan Chest Hospital, China and Gondar University Hospital, Ethiopia. The data were divided into derivation (n = 343; 60%) and validation groups (n = 227; 40%). A poor treatment outcome was defined as treatment failure, lost to follow up or death. A risk score for poor treatment outcomes was derived using a Cox proportional hazard model in the derivation group. The model was then validated in the validation group.
resultsThe overall rate of poor treatment outcome was 39.5% (n = 225); 37.9% (n = 86) in the derivation group and 40.5% (n = 139) in the validation group. Three variables were identified as predictors of poor treatment outcomes, and each was assigned a number of points proportional to its regression coefficient. These predictors and their points were: 1) history of taking second-line TB treatment (2 points), 2) resistance to any fluoroquinolones (3 points), and 3) smear did not convert from positive to negative at two months (4 points). We summed these points to calculate the risk score for each patient; three risk groups were defined: low risk (0 to 2 points), medium risk (3 to 5 points), and high risk (6 to 9 points). In the derivation group, poor treatment outcomes were reported for these three groups as 14%, 27%, and 71%, respectively. The area under the receiver operating characteristic curve for the point system in the derivation group was 0.69 (95% CI 0.60 to 0.77) and was similar to that in the validation group (0.67; 95% CI 0.56 to 0.78; p = 0.82).
conclusionHistory of second-line TB treatment, resistance to any fluoroquinolones, and smear non-conversion at two months can be used to estimate the risk of poor treatment outcome in patients with MDR-TB with a moderate degree of accuracy (AUROC = 0.69).
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