Evidence map›Paper›PMID 32603343›Full record

ArticlePloS one2020

The use of a borderline zone for the interpretation of interferon-gamma release assay results for serial screening of healthcare workers.

Jae Hyeon Park, Namhee Kim, Hyunwoong Park, Taek Soo Kim, Sang-Won Park, Eun Youn Roh, Jong Hyun Yoon, Sue Shin

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

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 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.1field-weighted citation impact, top 53% 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

5 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. Article
  3. Low TB1 and TB2 antigen-nil is associated with increased QuantiFERON Gold Plus reversions.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2026
    Article
  4. Review
  5. Review
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

8 authors at 1 institution in 1 country.

Jae Hyeon ParkDepartment of Laboratory Medicine, Seoul National University College of Medicine, Seoul, South Korea.ORCID 0000-0003-0261-2185
Namhee KimDepartment of Laboratory Medicine, Seoul National University College of Medicine, Seoul, South Korea.ORCID 0000-0002-9851-1727
Hyunwoong ParkDepartment of Laboratory Medicine, Seoul National University College of Medicine, Seoul, South Korea.ORCID 0000-0001-7765-2259
Taek Soo KimDepartment of Laboratory Medicine, Seoul National University College of Medicine, Seoul, South Korea.ORCID 0000-0002-2093-1721
Sang-Won ParkDepartment of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea.
Eun Youn RohDepartment of Laboratory Medicine, Seoul National University College of Medicine, Seoul, South Korea.ORCID 0000-0002-1787-7509
Jong Hyun YoonDepartment of Laboratory Medicine, Seoul National University College of Medicine, Seoul, South Korea.
Sue ShinDepartment of Laboratory Medicine, Seoul National University College of Medicine, Seoul, South Korea.
Seoul National University · KR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveAn interferon-gamma release assay (IGRA) is used to screen for latent tuberculosis infection (LTBI). Among IGRAs, the QuantiFERON-TB Gold In-Tube (QFT-GIT) results are highly variable, so the borderline zone has been proposed to reduce unnecessary LTBI treatment. The aim of this study was to examine the proportion of the borderline zone of QFT-GIT in healthcare workers' (HCWs) serial IGRA and to retrospectively identify the utility of predicting tuberculosis (TB) in a moderate TB incidence setting.

methodsThe participants were HCWs who had undergone serial LTBI screening between June 2013 and June 2018. IGRA-positive HCWs underwent examinations that included low-dose computed tomography (LDCT) and TB culture, if necessary. Applying the borderline zone (0.2-<0.7 IU/mL), the results were classified as definite negative, borderline negative, borderline positive and definite positive.

resultsThrough the follow-up of 477 HCWs, 441 (92.5%) invariant, 30 (6.3%) conversion, 2 (0.4%) reversion and 5 (1.0%) indeterminate results were observed with the manufacturer's cutoff. Applying the borderline zone, 419 (87.8%) invariant, 22 (4.6%) conversion, 1 (0.2%) reversion and 36 (7.5%) decision pending, including 5 (1.0%) indeterminate results, were observed. At the time of screening, five TB cases were identified. Chest X-ray (CXR) identified one TB case, and LDCT identified four additional TB cases. After one year, two TB cases were diagnosed, and their screening QFT-GIT results were definite positive and borderline negative. In the Cochran-Armitage trend test, the greater the maximum difference in the QFT-GIT grade with the borderline zone was, the higher the probability of developing TB (P-value <0.001).

conclusionThe application of the borderline zone lowered the conversion rate but increased the decision pending rate. Introducing the borderline zone requires a careful approach, and a thorough examination needs to be performed to rule out TB in converters. HCWs with borderline QFT-GIT results also need close observation.

Indexed as

Interferon-gamma Release TestsAdultFemaleHealth PersonnelHumansIncidenceLatent TuberculosisMaleMass ScreeningMiddle AgedRetrospective StudiesTuberculosisYoung Adult

Identifiers

PMID32603343
PMCPMC7326217
OpenAlexW3040464348

What OpenQuestion holds

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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.