Evidence map›Paper›PMID 35093849›Full record

ArticleEpidemics2022

Spatially targeted digital chest radiography to reduce tuberculosis in high-burden settings: A study of adaptive decision making.

Abigail K de Villiers, Christopher Dye, Reza Yaesoubi, Ted Cohen, Florian M Marx

Open access · goldAbstract read
In one paragraph

Article in Epidemics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.3field-weighted citation impact, top 46% 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

4 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. Article
  3. Integrating testing volume into bandit algorithms for infectious disease surveillance.Journal of the Royal Statistical Society. Series A, (Statistics in Society) · 2025
    Article
  4. 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

5 authors at 4 institutions in 3 countries.

Abigail K de VilliersDSI-NRF South African Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Western Cape, South Africa. Electronic address: adevilliers@sun.ac.za.
Christopher DyeDepartment of Biology, University of Oxford, Oxford, United Kingdom. Electronic address: christopher.dye@zoo.ox.ac.uk.
Reza YaesoubiDepartment of Health Policy and Management and the Public Health Modeling Unit, Yale School of Public Health, New Haven, USA. Electronic address: reza.yaesoubi@yale.edu.
Ted CohenDepartment of Epidemiology of Microbial Diseases and the Public Health Modeling Unit, Yale School of Public Health, New Haven, USA. Electronic address: ted.cohen@gmail.com.
Florian M MarxDSI-NRF South African Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Western Cape, South Africa; Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa. Electronic address: fmarx@sun.ac.za.
Desmond Tutu HIV Foundation · ZAStellenbosch University · ZAUniversity of Oxford · GBYale New Haven Health System · US

Funding

Improving the control of multidrug-resistant tuberculosis through targeted screening and use of novel anti-tuberculosis drugsK01AI119603 · NIAID · YALE UNIVERSITY · PI YAESOUBI, REZA · 2016 to 2019
$518k
NIAID NIH HHS K01 AI119603
6 · The paper itself

Abstract

backgroundSpatially-targeted approaches to screen for tuberculosis (TB) could accelerate TB control in high-burden populations. We aimed to estimate gains in case-finding yield under an adaptive decision-making approach for spatially-targeted, mobile digital chest radiography (dCXR)-based screening in communities with varying levels of TB prevalence.

methodsWe used a Monte-Carlo simulation model to simulate a spatially-targeted screening intervention in 24 communities with TB prevalence estimates derived from a large community-randomized trial. We implemented a Thompson sampling algorithm to allocate screening units based on Bayesian probabilities of local TB prevalence that are continuously updated during weekly screening rounds. Four mobile units for dCXR-based screening and subsequent Xpert Ultra-based testing were allocated among the communities during a 52-week period. We estimated the yield of bacteriologically-confirmed TB per 1000 screenings comparing scenarios of spatially-targeted and untargeted resource allocation.

resultsWe estimated that under the untargeted scenario, an expected 666 (95% uncertainty interval 522-825) TB cases would be detected over one year, equivalent to 8.9 (7.5-10.3) per 1000 individuals screened. Allocating the screening units to the communities with the highest (prior-year) cases notification rates resulted in an expected 760 (617-926) TB cases detected, 10.1 (8.6-11.8) per 1000 screened. Adaptive, spatially-targeted screening resulted in an expected 1241 (995-1502) TB cases detected, 16.5 (14.5-18.7) per 1000 screened. Numbers of dCXR-based screenings needed to detect one additional TB case declined during the first 12-14 weeks as a result of Bayesian learning.

conclusionWe introduce a spatially-targeted screening strategy that could reduce the number of screenings necessary to detect additional TB in high-burden settings and thus improve the efficiency of screening interventions. Empirical trials are needed to determine whether this approach could be successfully implemented.

Indexed as

TuberculosisBayes TheoremDecision MakingHumansMass ScreeningRadiographyAdaptive decision makingCase findingDigital chest radiographyScreeningTuberculosis

Identifiers

PMID35093849
PMCPMC8983993
OpenAlexW4206916291

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.