ReviewInternational health2023
The therapeutic threshold in clinical decision-making for TB.
Review in International health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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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.
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Who cites it
4 citing papers in PubMed.
- Estimation of therapeutic threshold for tuberculosis using adapted nominal group technique and clinical vignettes in clinical and community settings in Southern Africa.Journal of clinical tuberculosis and other mycobacterial diseases · 2025Article
- Patient experiences of tuberculosis treatment deferral after a trace Xpert Ultra result: a prospective cohort study.Infectious diseases of poverty · 2025Article
- Low tuberculosis treatment initiation after positive tuberculosis lipoarabinomannan results.ERJ open research · 2024Article
- Piloting a new method to estimate action thresholds in medicine through intuitive weighing.BMJ evidence-based medicine · 2023Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Because TB control is still hampered by the limitations of diagnostic tools, diagnostic uncertainty is common. The decision to offer treatment is based on clinical decision-making. The therapeutic threshold, test threshold and test-treatment threshold can guide in making these decisions. This review summarizes the literature on methods to estimate the therapeutic threshold that have been applied for TB. Only five studies estimated the threshold for the diagnosis of TB. The therapeutic threshold can be estimated by prescriptive methods, based on calculations, and by descriptive methods, deriving the threshold from observing clinical practice. Test and test-treatment thresholds can be calculated using the therapeutic threshold and the characteristics of an available diagnostic test. Estimates of the therapeutic threshold for pulmonary TB from intuitive descriptive approaches (20%-50%) are higher than theoretical prescriptive calculations (2%-3%). In conclusion, estimates of the therapeutic threshold for pulmonary TB depend on the method used. Other methods exist within the field of decision-making that have yet to be implemented or adapted as tools to estimate the TB therapeutic threshold. Because clinical decision-making is a core element of TB management, it is necessary to find a new, clinician-friendly way to unbiasedly estimate context-specific, agreed upon therapeutic thresholds.
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Registered trials
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