Evidence map›Paper›PMID 42203236›Full record

SynthesisEuropean respiratory review : an official journal of the European Respiratory Society2026

Multidimensional determinants of BCG-induced false-positivity in tuberculin skin testing: a global meta-analysis of 242 studies.

Shunli Cai, Yuan Xia, Yingchen Zhou, Yangxuan Lin, Xin Guo, Yan Dong, Hongbo Chen, Jian He, Chao Song, Guozhong Zhou

Abstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in European respiratory review : an official journal of the European Respiratory Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

10 authors.

Shunli CaiFaculty of Life Science and Technology and The affiliated Anning First People's Hospital, Kunming University of Science and Technology, Kunming, China.
Yuan XiaSchool of Basic Medical Sciences, Kunming Medical University, Kunming, China.
Yingchen ZhouThe School of Medicine, Kunming University, Kunming, China.
Yangxuan LinSchool of Basic Medical Sciences, Kunming Medical University, Kunming, China.
Xin GuoFaculty of Life Science and Technology and The affiliated Anning First People's Hospital, Kunming University of Science and Technology, Kunming, China.
Yan DongDepartment of Science and Research, The Affiliated Anning First People's Hospital of Kunming University of Science and Technology, Kunming, China.
Hongbo ChenDepartment of Pulmonary and Critical Care Medicine, Anning First People's Hospital Affiliated to Kunming University of Science and Technology, Kunming, China.
Jian HeDepartment of Pulmonary and Critical Care Medicine, Anning First People's Hospital Affiliated to Kunming University of Science and Technology, Kunming, China.
Chao SongDepartment of Medical Imaging, Anning First People's Hospital Affiliated to Kunming University of Science and Technology, Kunming, China.
Guozhong ZhouDepartment of Science and Research, The Affiliated Anning First People's Hospital of Kunming University of Science and Technology, Kunming, China 20220247@kust.edu.cn.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe tuberculin skin test (TST), widely used for latent tuberculosis infection (LTBI) screening, shows reduced specificity in Bacillus Calmette-Guérin (BCG)-vaccinated individuals due to antigenic cross-reactivity. We aimed to quantify the impact of BCG vaccination on false-positive TST results and to identify key modifying factors.

methodsWe systematically searched Embase, PubMed, Web of Science and the Cochrane Library up to 24 February 2025. A dual-comparison design was applied: head-to-head comparisons of interferon-γ release assay (IGRA)

resultsA total of 242 studies were included, with 166 head-to-head (50 341 participants) and 176 between-group comparisons (456 429 participants). Both approaches yielded consistent estimates, including a head-to-head RD of 13% (95% CI 9-16%) and a between-group RD of 12% (95% CI 9-14%). False positivity decreased with increasing tuberculosis incidence and latitude. Immunosuppressed individuals showed lower RDs than general populations. BCG strain, age at vaccination and number of doses significantly influenced false positivity.

conclusionsWe identified key modifiers of BCG-related TST false positivity. TST remains appropriate in high-incidence settings and for BCG specific strains, whereas IGRA may be preferred in low-incidence areas, in individuals vaccinated multiple times or in immunosuppressed individuals.

Indexed as

BCG VaccineLatent TuberculosisTuberculin TestAdultFalse Positive ReactionsFemaleHumansInterferon-gamma Release TestsMalePredictive Value of TestsRisk FactorsVaccinationBCG Vaccine

Identifiers

PMID42203236
PMCPMC13213458

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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.