A statistical method was used for the meta-analysis of tests for latent TB in the absence of a gold standard, combining random-effect and latent-class methods to estimate test accuracy

Sadatsafavi, Mohsen; Shahidi, Neal; Marra, Fawziah; FitzGerald, Mark; Elwood, Kevin; Guo, Na; Marra, Carlo

doi:10.1016/j.jclinepi.2009.04.008

Cited by 38 publications

(57 citation statements)

References 51 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We recognise the limitation of applying prior information into our model with relatively limited data as priors are subjective and may influence the final results. However, our choice of prior distribution used was based on prior information derived from a recent meta-analysis performed on published studies 7 8. Sensitivity analyses also showed that our results were data driven, and were not overly influenced by prior information.…”

Section: Discussionmentioning

confidence: 94%

“…Hence it is appropriate to be used as the prior distribution for the prevalence of TAU, sensitivity and specificity of each test. Due to the lack of similar studies, we used the information from a meta-analysis of published studies representing different populations, which analysed the sensitivity and specificity of each test in the absence of a gold standard, as the next best alternative 7. The prior information for sensitivity and specificity of TST and T-SPOT.TB that were used are presented in table 1.…”

Section: Methodsmentioning

confidence: 99%

“…When evaluating new medical diagnostic tests, data may be obtained from one or more tests, but none of these can be considered a gold standard, ie, a diagnostic test with 100% sensitivity and specificity 7 8. Bayesian analysis allows the disease prevalence, sensitivity and specificity of a diagnostic test to be estimated in the absence of a gold standard test without placing constraints on any of the test parameters 8.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Interferon γ release assay for the diagnosis of uveitis associated with tuberculosis: a Bayesian evaluation in the absence of a gold standard

Ang

Wong

et al. 2013

Br J Ophthalmol

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 94%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Interferon γ release assay for the diagnosis of uveitis associated with tuberculosis: a Bayesian evaluation in the absence of a gold standard

Ang

Wong

et al. 2013

Br J Ophthalmol

View full text Add to dashboard Cite

show abstract

“…Due to the inherent difficulties associated with comparing studies without head-to-head comparisons, without both sensitivity and specificity being calculated, and with variability in the TST positivity cutoff, Sadatsafavi et al applied statistical methods and performed a latentclass meta-analysis for the estimation of test accuracy (15). Their analyses showed sensitivities of 71%, 64%, and 50% and specificities of 68%, 99%, and 91% for the TST, QFT, and T-SPOT, respectively.…”

Section: Counterpointmentioning

confidence: 99%

Point-Counterpoint: Should Interferon Gamma Release Assays Become the Standard Method for Screening Patients for Mycobacterium tuberculosis Infections in the United States?

2011

View full text Add to dashboard Cite

The Centers for Disease Control and Prevention recently published updated guidelines for the use of interferon gamma release assays (IGRAs) to detect Mycobacterium tuberculosis . This document gives a balanced analysis of the strengths and weaknesses of IGRAs. To date, these assays have not been widely adopted in the United States by clinical laboratories. We have asked two experts, Thomas Alexander of Summa Health Care, who has adopted an IGRA for M. tuberculosis detection in his laboratory, and Melissa Miller of UNC Hospitals, who has evaluated one but has not chosen to adopt it, to explain how each reached this decision based on their experience with the test and the data that have been published concerning IGRA.

show abstract

“…Assessment of test performance is limited by the absence of a gold standard for comparison, but longitudinal follow-up and modelling studies suggest a significantly higher specificity and positive predictive value for IGRA than TST. 16,17 Perhaps the most accurate assessment for risk of latent tuberculosis results from a combination of tests and clinical review, including history of exposure and past treatment. However, this requires a higher degree of expertise than is provided by simple, dichotomous, interpretation of test results and is correspondingly more resource intensive than other alternatives.…”

mentioning

confidence: 99%

Ethical evaluation of immigration screening policy for latent tuberculosis infection

Denholm

McBryde

Brown

2012

Australian and New Zealand Journal of Public Health

View full text Add to dashboard Cite

Key words: ethics, latent tuberculosis, immigration, public health, interferongamma release assays, tuberculin test Aust NZ J Public Health. 2012; 36:325-8 doi: 10.1111/j.1753-6405.2012 could operate in a variety of ways, which would aim to detect LTBI in immigrants to Australia or NZ and provide treatment to prevent later disease.In addition to any logistic considerations, such policies raise a number of ethical implications that require careful analysis prior to implementation. The focus of this article is to review the potential alternatives for the introduction of LTBI screening into Australasian immigration policy, with a particular emphasis on the ethical evaluation of various strategies. MethodsCurrent Australian and NZ immigration policies related to tuberculosis were reviewed. Relevant Federal Government department websites and publications were accessed to summarise immigration screening approaches to tuberculosis infection.Introduction of screening and treatment for LTBI could be incorporated into new public health policy with a variety of permutations. Key elements of such changes were extracted and described in order to allow ethical evaluation of various permutations in policy development. Denholm, McBryde and Brown ArticleA number of frameworks have been proposed for the ethical evaluation of public health policy, including immigration screening. Some approaches have emphasised national sovereignty, with its rights (or even obligations) to exercise immigration control on behalf of its citizens. 8 Other approaches have rejected national interests in favour of more universal considerations. Particularly influential in this regard have been approaches based on human rights considerations, such as the models adapted for assessment of mandatory HIV screening.9,10 Such approaches emphasise limiting the burdens of screening on immigrants, particularly through appropriate targeting and adopting the least restrictive alternatives which achieve the desired public health benefit.While a number of frameworks could be applied to the evaluation of public health policy, few have been developed specifically with this context in mind. One exception is the principle-based analytic approach proposed by Nancy Kass.11 This approach seeks to take into account the dynamic tension between harms and benefits to individuals and societies, and encourages systematic evaluation of public health policy on ethical grounds. The central concepts within this framework are the design of public health policy which minimises burdens and maximises benefits, and the fair allocation of those burdens and benefits. This present analysis adopts these principles in order to consider the ethical implications of potential public health policy changes in relation to immigration screening for LTBI. Results Existing Australasian immigration policiesCurrently, most applicants for immigration to Australia or NZ are required to undergo an assessment for active tuberculosis. 12,13 Requirements for both countries are similar, primarily consisti...

show abstract

A statistical method was used for the meta-analysis of tests for latent TB in the absence of a gold standard, combining random-effect and latent-class methods to estimate test accuracy

Cited by 38 publications

References 51 publications

Interferon γ release assay for the diagnosis of uveitis associated with tuberculosis: a Bayesian evaluation in the absence of a gold standard

Interferon γ release assay for the diagnosis of uveitis associated with tuberculosis: a Bayesian evaluation in the absence of a gold standard

Point-Counterpoint: Should Interferon Gamma Release Assays Become the Standard Method for Screening Patients for Mycobacterium tuberculosis Infections in the United States?

Ethical evaluation of immigration screening policy for latent tuberculosis infection

Contact Info

Product

Resources

About