Evidence map›Paper›PMID 40551790›Full record

ArticleERJ open research2025

Latent tuberculosis infection screening of adult close contacts: a cost-utility analysis.

Nathan Green, Kavina Manalan, Manabu Hayama, Marie O'Donoghue, Suranjith Seneviratne, Nicholas Drey, Onn Min Kon

Abstract read
In one paragraph

Article in ERJ open research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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

7 authors.

Nathan GreenDepartment of Statistical Science, University College London, London, UK.
Kavina ManalanTuberculosis Service, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK.
Manabu HayamaImperial College London, London, UK.
Marie O'DonoghueTuberculosis Service, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK.
Suranjith SeneviratneRoyal Free London NHS Trust, London, UK.ORCID https://orcid.org/0000-0002-6548-5673
Nicholas DreySchool of Health Sciences, City, University of London, London, UK.
Onn Min KonTuberculosis Service, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK.ORCID https://orcid.org/0000-0003-2647-4688

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The 2016 National Institute for Health and Care Excellence guidelines recommended the tuberculin skin test (TST), at a 5-mm induration size cut-off, for the diagnosis of latent tuberculosis infection (LTBI) among adult close contacts of active tuberculosis (TB) cases. This study analysed a well-characterised cohort of adult close contacts in London and assessed the cost-effectiveness of LTBI screening strategies with combinations of TST and interferon-γ release assays (IGRAs) in a decision-analytic model. Methods: Close contacts of pulmonary TB cases who were tested with TST and IGRA between January 2008 and December 2010 were retrospectively reviewed. Using an NHS perspective and lifetime horizon, a decision-analytic Markov model was used to compare costs and quality-adjusted life-years (QALYs) associated with five screening strategies followed by LTBI treatment: 1) TST alone; 2) QuantiFERON-TB Gold In-Tube (QFT) alone; 3) T-SPOT.TB (T-SPOT) alone; 4) TST positive followed by QFT; 5) TST positive followed by T-SPOT. Results: This study included 381 asymptomatic close contacts aged 18 to 65 years (mean±sd 35.2±11.3). 75.3% had received BCG vaccination. Among the five strategies, for a willingness-to-pay threshold of GBP 25 000 and using incremental net monetary benefit (INMB) with TST as comparator, the IGRA-alone strategies were the most cost-effective, marginally QFT over T-SPOT (QFT: GBP 214; T-SPOT: GBP 199). Conclusion: Single-step IGRA, particularly QuantiFERON, is preferable for LTBI screening of adult close contacts of pulmonary TB cases.

Identifiers

PMID40551790
PMCPMC12183743

What OpenQuestion holds

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Registered trials

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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.