Evidence map›Paper›PMID 32414338›Full record

Trial reportBMC infectious diseases2020

Ultrasound in managing extrapulmonary tuberculosis: a randomized controlled two-center study.

Robert Ndege, Omary Ngome, Farida Bani, Yvan Temba, Herieth Wilson, Fiona Vanobberghen, Jerry Hella, Winfrid Gingo, Mohamed Sasamalo, Dorcas Mnzava and 11 more

Open access · goldAbstract readMulticenter StudyRandomized Controlled TrialEquivalence Trial
In one paragraph

Trial report in BMC infectious diseases, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
1.4field-weighted citation impact, top 18% 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

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.

  1. Pooled it
  2. Ultrasononography in Managing Extrapulmonary Tuberculosis: A Randomized, Controlled, Parallel, Superiority, Open-Label Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023
    Trial
  3. Article
  4. Article
  5. Review
  6. Article
  7. Peripancreatic lymph node tuberculosis diagnosed by endoscopic ultrasound.JGH open : an open access journal of gastroenterology and hepatology · 2021
    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

21 authors at 5 institutions in 2 countries.

Robert NdegeIfakara Health Institute, Ifakara, United Republic of Tanzania, Off Mlabani Passage, P. O Box 53, Ifakara, Tanzania. rndege@ihi.or.tz.
Omary NgomeIfakara Health Institute, Ifakara, United Republic of Tanzania, Off Mlabani Passage, P. O Box 53, Ifakara, Tanzania.
Farida BaniIfakara Health Institute, Ifakara, United Republic of Tanzania, Off Mlabani Passage, P. O Box 53, Ifakara, Tanzania.
Yvan TembaIfakara Health Institute, Ifakara, United Republic of Tanzania, Off Mlabani Passage, P. O Box 53, Ifakara, Tanzania.
Herieth WilsonIfakara Health Institute, Ifakara, United Republic of Tanzania, Off Mlabani Passage, P. O Box 53, Ifakara, Tanzania.
Fiona VanobberghenDepartment of Medicine, Swiss Tropical and Public Health Institute, Basel, Switzerland.
Jerry HellaIfakara Health Institute, Ifakara, United Republic of Tanzania, Off Mlabani Passage, P. O Box 53, Ifakara, Tanzania.
Winfrid GingoSt Francis Referral Hospital, Ifakara, United Republic of Tanzania.
Mohamed SasamaloIfakara Health Institute, Ifakara, United Republic of Tanzania, Off Mlabani Passage, P. O Box 53, Ifakara, Tanzania.
Dorcas MnzavaIfakara Health Institute, Ifakara, United Republic of Tanzania, Off Mlabani Passage, P. O Box 53, Ifakara, Tanzania.
Namvua KimeraIfakara Health Institute, Ifakara, United Republic of Tanzania, Off Mlabani Passage, P. O Box 53, Ifakara, Tanzania.
Helen HizaIfakara Health Institute, Ifakara, United Republic of Tanzania, Off Mlabani Passage, P. O Box 53, Ifakara, Tanzania.
John WigayiIfakara Health Institute, Ifakara, United Republic of Tanzania, Off Mlabani Passage, P. O Box 53, Ifakara, Tanzania.
Herry MapesiIfakara Health Institute, Ifakara, United Republic of Tanzania, Off Mlabani Passage, P. O Box 53, Ifakara, Tanzania.
Irene B KatoMwananyamala Regional Referral Hospital, Dar es salaam, United Republic of Tanzania.
Francis MhimbiraIfakara Health Institute, Ifakara, United Republic of Tanzania, Off Mlabani Passage, P. O Box 53, Ifakara, Tanzania.
Klaus ReitherDepartment of Medicine, Swiss Tropical and Public Health Institute, Basel, Switzerland.
Manuel BattegayFaculty of Medicine, University of Basel, Basel, Switzerland.
Daniel H ParisDepartment of Medicine, Swiss Tropical and Public Health Institute, Basel, Switzerland.
Maja WeisserIfakara Health Institute, Ifakara, United Republic of Tanzania, Off Mlabani Passage, P. O Box 53, Ifakara, Tanzania.
Martin RohacekIfakara Health Institute, Ifakara, United Republic of Tanzania, Off Mlabani Passage, P. O Box 53, Ifakara, Tanzania. mrohacek@ihi.or.tz.
Ifakara Health Institute · TZSt. Francis Referral Hospital · TZUniversity of Basel · CHSwiss Tropical and Public Health Institute · CHUniversity Hospital of Basel · CH

Funding

Gottfried and Julia Bangerter-Rhyner Foundation, Basel, Switzerland N/ARudolf Geigy Foundation Basel, Switzerland N/A
6 · The paper itself

Abstract

backgroundPatients with clinically suspected tuberculosis are often treated empirically, as diagnosis - especially of extrapulmonary tuberculosis - remains challenging. This leads to an overtreatment of tuberculosis and to underdiagnosis of possible differential diagnoses.

methodsThis open-label, parallel-group, superiority randomized controlled trial is done in a rural and an urban center in Tanzania. HIV-positive and -negative adults (≥18 years) with clinically suspected extrapulmonary tuberculosis are randomized in a 1:1 ratio to an intervention- or control group, stratified by center and HIV status. The intervention consists of a management algorithm including extended focused assessment of sonography for HIV and tuberculosis (eFASH) in combination with chest X-ray and microbiological tests. Treatment with anti-tuberculosis drugs is started, if eFASH is positive, chest X-ray suggests tuberculosis, or a microbiological result is positive for tuberculosis. Patients in the control group are managed according national guidelines. Treatment is started if microbiology is positive or empirically according to the treating physician. The primary outcome is the proportion of correctly managed patients at 6 months (i.e patients who were treated with anti-tuberculosis treatment and had definite or probable tuberculosis, and patients who were not treated with anti-tuberculosis treatment and did not have tuberculosis). Secondary outcomes are the proportion of symptom-free patients at two and 6 months, and time to death. The sample size is 650 patients. DISCUSSION: This study will determine, whether ultrasound in combination with other tests can increase the proportion of correctly managed patients with clinically suspected extrapulmonary tuberculosis, thus reducing overtreatment with anti-tuberculosis drugs.

trial registrationPACTR, Registration number: PACTR201712002829221, registered December 1st 2017.

Indexed as

AdultFemaleHumansMaleMiddle AgedRadiographyTanzaniaTuberculosisUltrasonographyExtrapulmonaryFASHSonographySub-Saharan AfricaTuberculosis

Identifiers

PMID32414338
PMCPMC7226714
OpenAlexW3025011360

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.