دورية أكاديمية
Interferon gamma release assays for diagnostic evaluation of active tuberculosis (IDEA): test accuracy study and economic evaluation
| العنوان: | Interferon gamma release assays for diagnostic evaluation of active tuberculosis (IDEA): test accuracy study and economic evaluation |
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| المؤلفون: | Takwoingi, Y, Whitworth, H, Rees-Roberts, M, Badhan, A, Partlett, C, Green, N, Boakye, A, Lambie, H, Marongiu, L, Jit, M, White, P, Deeks, JJ, Kon, OM, Lalvani, A, Abdoyeku, D, Branley, H, Chua, F, Conlon, C, Cooke, G, Davison, R, Dedicoat, M, Kunst, H, Lipman, M, Loebingher, M, Lynn, W, Macallan, D, Menzies, S, Nathani, N, O'Connell, R, Post, F, Pozniak, A, Wiselka, M, Woltmann, G |
| المساهمون: | National Institute for Health Research |
| بيانات النشر: | NIHR Journals Library |
| سنة النشر: | 2016 |
| المجموعة: | Imperial College London: Spiral |
| مصطلحات موضوعية: | Science & Technology, Life Sciences & Biomedicine, Health Care Sciences & Services, GOLD IN-TUBE, SKIN-TEST, LOGISTIC-REGRESSION, LATENT TUBERCULOSIS, LIKELIHOOD RATIOS, TB, UTILITY, PULMONARY, SENSITIVITY, EXTRAPULMONARY, CFP-10, DIAGNOSIS, ELISPOT, ESAT-6, INTERFERON GAMMA, QUANTIFERON GOLD IN TUBE, RV2654, RV3615C, RV3873, RV3879C, SPECIFICITY, T-SPOT.TB, TUBERCULOSIS, Health Policy & Services, 1117 Public Health and Health Services, 0807 Library and Information Studies, 0806 Information Systems |
| الوصف: | Background Interferon gamma release assays (IGRAs) are blood tests recommended for the diagnosis of tuberculosis (TB) infection. There is currently uncertainty about the role and clinical utility of IGRAs in the diagnostic workup of suspected active TB in routine NHS clinical practice. Objectives To compare the diagnostic accuracy and cost-effectiveness of T-SPOT.TB® (Oxford Immunotec, Abingdon, UK) and QuantiFERON® TB GOLD In-Tube (Cellestis, Carnegie, VIC, Australia) for diagnosis of suspected active TB and to estimate the diagnostic accuracy of second-generation IGRAs. Design Prospective within-patient comparative diagnostic accuracy study. Setting Secondary care. Participants Adults (aged ≥ 16 years) presenting as inpatients or outpatients at 12 NHS hospital trusts in London, Slough, Oxford, Leicester and Birmingham with suspected active TB. Interventions The index tests [T-SPOT.TB and QuantiFERON GOLD In-Tube (QFT-GIT)] and new enzyme-linked immunospot assays utilising novel Mycobacterium tuberculosis antigens (Rv3615c, Rv2654, Rv3879c and Rv3873) were verified against a composite reference standard applied by a panel of clinical experts blinded to IGRA results. Main outcome measures Sensitivity, specificity, predictive values and likelihood ratios were calculated to determine diagnostic accuracy. A decision tree model was developed to calculate the incremental costs and incremental health utilities [quality-adjusted life-years (QALYs)] of changing from current practice to using an IGRA as an initial rule-out test. Results A total of 363 patients had active TB (culture-confirmed and highly probable TB cases), 439 had no active TB and 43 had an indeterminate final diagnosis. Comparing T-SPOT.TB and QFT-GIT, the sensitivities [95% confidence interval (CI)] were 82.3% (95% CI 77.7% to 85.9%) and 67.3% (95% CI 62.1% to 72.2%), respectively, whereas specificities were 82.6% (95% CI 78.6% to 86.1%) and 80.4% (95% CI 76.1% to 84.1%), respectively. T-SPOT.TB was more sensitive than QFT-GIT (relative sensitivity ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| تدمد: | 1366-5278 |
| العلاقة: | Health Technology Assessment; http://hdl.handle.net/10044/1/70781Test; https://doi.org/10.3310/hta23230Test; 08/106/02 |
| DOI: | 10.3310/hta23230 |
| الإتاحة: | https://doi.org/10.3310/hta23230Test http://hdl.handle.net/10044/1/70781Test |
| حقوق: | © 2019 Queen’s Printer and Controller of HMSO. This work was produced by Takwoingi et al. under the terms of a commissioning contract issued by the Secretary of State for Health and Social Care. This issue may be freely reproduced for the purposes of private research and study and extracts (or indeed, the full report) may be included in professional journals provided that suitable acknowledgement is made and the reproduction is not associated with any form of advertising. Applications for commercial reproduction should be addressed to: NIHR Journals Library, National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK. |
| رقم الانضمام: | edsbas.1121367D |
| قاعدة البيانات: | BASE |
Full Text Finder | تدمد: | 13665278 |
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| DOI: | 10.3310/hta23230 |