Evidence map›Paper›PMID 32041772›Full record

ArticleGlobal health, science and practice2020

Diagnostic Utility and Impact on Clinical Decision Making of Focused Assessment With Sonography for HIV-Associated Tuberculosis in Malawi: A Prospective Cohort Study.

Daniel Kahn, Kara-Lee Pool, Linna Phiri, Florence Chibwana, Kristin Schwab, Levison Longwe, Ben Allan Banda, Khumbo Gama, Mayamiko Chimombo, Chifundo Chipungu and 3 more

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Global health, science and practice, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05364593 (Evaluating Point-of-care Ultrasound to Improve Tuberculosis Diagnosis in Children), which is not on this map. Cited by 12 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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.

NCT05364593 completednot on this map

Evaluating Point-of-care Ultrasound to Improve Tuberculosis Diagnosis in Children

Typeobservational_patient_registrySponsorMedecins Sans Frontieres, SpainRan2019 to 2023Enrolled576ConditionsTuberculosis
3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 1 synthesis or guideline pooled it.

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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

13 authors.

Daniel KahnDepartment of Internal Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA. DaKahn@mednet.ucla.edu.
Kara-Lee PoolDepartment of Radiology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA.
Linna PhiriPartners in Hope, Lilongwe, Malawi.
Florence ChibwanaPartners in Hope, Lilongwe, Malawi.
Kristin SchwabDepartment of Medicine, Division of Pulmonology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA.
Levison LongwePartners in Hope, Lilongwe, Malawi.
Ben Allan BandaPartners in Hope, Lilongwe, Malawi.
Khumbo GamaPartners in Hope, Lilongwe, Malawi.
Mayamiko ChimomboPartners in Hope, Lilongwe, Malawi.
Chifundo ChipunguPartners in Hope, Lilongwe, Malawi.
Jonathan GrottsDepartment of Medicine Statistics Core, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA.
Alan SchooleyPartners in Hope, Lilongwe, Malawi.
Risa M HoffmanDepartment of Medicine, Division of Infectious Disease, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA.

Funding

PEPFAR AID-OAA-A-15-00070
6 · The paper itself

Abstract

backgroundThe focused assessment with sonography for HIV-associated tuberculosis (TB) (FASH) ultrasound protocol has been increasingly used to help clinicians diagnose TB. We sought to quantify the diagnostic utility of FASH for TB among individuals with HIV in Malawi.

methodsBetween March 2016 and August 2017, 210 adults with HIV who had 2 or more signs and symptoms that were concerning for TB (fever, cough, night sweats, weight loss) were enrolled from a public HIV clinic in Lilongwe, Malawi. The treating clinicians conducted a history, physical exam, FASH protocol, and additional TB evaluation (laboratory diagnostics and chest radiography) on all participants. The clinician made a final treatment decision based on all available information. At the 6-month follow-up visit, we categorized participants based on clinical outcomes and diagnostic tests as having probable/confirmed TB or unlikely TB; association of FASH with probable/confirmed TB was calculated using Fisher's exact tests. The impact of FASH on empiric TB treatment was determined by asking the clinicians prospectively about whether they would start treatment at 2 time points in the baseline visit: (1) after the initial history and physical exam; and (2) after history, physical exam, and FASH protocol.

resultsA total of 181 participants underwent final analysis, of whom 56 were categorized as probable/confirmed TB and 125 were categorized as unlikely TB. The FASH protocol was positive in 71% (40/56) of participants with probable/confirmed TB compared to 24% (30/125) of participants with unlikely TB (odds ratio=7.9, 95% confidence interval=3.9,16.1;

conclusionIn the setting of HIV coinfection in Malawi, FASH can be a helpful tool that augments the clinician's ability to make a timely diagnosis of TB.

Indexed as

Point-of-Care TestingAdultAntitubercular AgentsAscitesCohort StudiesCoinfectionFemaleHIV InfectionsHumansLipopolysaccharidesLiverLymphadenopathyMalawiMaleMiddle AgedNucleic Acid Amplification TechniquesAntitubercular AgentslipoarabinomannanLipopolysaccharides

Identifiers

PMID32041772
PMCPMC7108937

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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.