Evidence map›Paper›PMID 34604724›Full record

ArticleEClinicalMedicine2021

Does tuberculosis screening improve individual outcomes? A systematic review.

L Telisinghe, M Ruperez, M Amofa-Sekyi, L Mwenge, T Mainga, R Kumar, M Hassan, L H Chaisson, F Naufal, A E Shapiro and 10 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in EClinicalMedicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing 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.

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

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

  1. Number needed to screen for TB in clinical, structural or occupational risk groups.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2022
    Pooled it
  2. Genomic epidemiology ofMicrobial genomics · 2026
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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

20 authors.

L TelisingheLondon School of Hygiene and Tropical Medicine, London, UK.
M RuperezLondon School of Hygiene and Tropical Medicine, London, UK.
M Amofa-SekyiZambart, University of Zambia School of Public Health, Ridgeway, Zambia.
L MwengeZambart, University of Zambia School of Public Health, Ridgeway, Zambia.
T MaingaZambart, University of Zambia School of Public Health, Ridgeway, Zambia.
R KumarZambart, University of Zambia School of Public Health, Ridgeway, Zambia.
M HassanUniversity Hospitals Plymouth NHS Trust, UK.
L H ChaissonDivision of Infectious Diseases, Department of Medicine, University of Illinois at Chicago, Chicago, USA.
F NaufalWilmer Eye Institute, Johns Hopkins University, Baltimore, USA.
A E ShapiroDepartments of Global Health and Medicine, University of Washington, Seattle, USA.
J E GolubJohns Hopkins University School of Medicine, Center for Tuberculosis Research, Baltimore, USA.
C MillerGlobal TB programme, World Health Organization, Geneva, Switzerland.
E L CorbettLondon School of Hygiene and Tropical Medicine, London, UK.
R M BurkeLondon School of Hygiene and Tropical Medicine, London, UK.
P MacPhersonLondon School of Hygiene and Tropical Medicine, London, UK.
R J HayesLondon School of Hygiene and Tropical Medicine, London, UK.
V BondLondon School of Hygiene and Tropical Medicine, London, UK.
C DaneshvarUniversity Hospitals Plymouth NHS Trust, UK.
E KlinkenbergLondon School of Hygiene and Tropical Medicine, London, UK.
H M AylesLondon School of Hygiene and Tropical Medicine, London, UK.

Funding

Novel clinic-based TB diagnostics and testing algorithms for persons with HIVK23AI140918 · NIAID · UNIVERSITY OF WASHINGTON · PI SHAPIRO, ADRIENNE E · 2019 to 2024
$937k
Medical Research Council MR/N020618/1Medical Research Council MR/R010161/1NIAID NIH HHS K23 AI140918Wellcome TrustWorld Health Organization 001
6 · The paper itself

Abstract

backgroundTo determine if tuberculosis (TB) screening improves patient outcomes, we conducted two systematic reviews to investigate the effect of TB screening on diagnosis, treatment outcomes, deaths (clinical review assessing 23 outcome indicators); and patient costs (economic review).

methodsPubmed, EMBASE, Scopus and the Cochrane Library were searched between 1/1/1980-13/4/2020 (clinical review) and 1/1/2010-14/8/2020 (economic review). As studies were heterogeneous, data synthesis was narrative.

findingsClinical review: of 27,270 articles, 18 (n=3 trials) were eligible. Nine involved general populations. Compared to passive case finding (PCF), studies showed lower smear grade (n=2/3) and time to diagnosis (n=2/3); higher pre-treatment losses to follow-up (screened 23% and 29% vs PCF 15% and 14%; n=2/2); and similar treatment success (range 68-81%; n=4) and case fatality (range 3-11%; n=5) in the screened group. Nine reported on risk groups. Compared to PCF, studies showed lower smear positivity among those culture-confirmed (n=3/4) and time to diagnosis (n=2/2); and similar (range 80-90%; n=2/2) treatment success in the screened group. Case fatality was lower in n=2/3 observational studies; both reported on established screening programmes. A neonatal trial and post-hoc analysis of a household contacts trial found screening was associated with lower all-cause mortality. Economic review: From 2841 articles, six observational studies were eligible. Total costs (n=6) and catastrophic cost prevalence (n=4; range screened 9-45% vs PCF 12-61%) was lower among those screened.

interpretationWe found very limited patient outcome data. Collecting and reporting this data must be prioritised to inform policy and practice.

fundingWHO and EDCTP.

Indexed as

Active case-findingCase fatalityCatastrophic costsDisease severityEconomic consequencesEnhanced case-findingIndividual effectsMortalityPatient costsScreeningTreatment outcomes

Identifiers

PMID34604724
PMCPMC8473670

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.