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Peer reviewedOpen accessTuberculosis

Prognostic value of interferon-γ release assays and tuberculin skin test in predicting the development of active tuberculosis (UK PREDICT TB): a prospective cohort study

The Lancet Infectious Diseases·

Ibrahim Abubakar, Francis Drobniewski, Jo Southern, Alice J Sitch, Charlotte Jackson, Marc Lipman, Jonathan J Deeks, Chris Griffiths, Graham Bothamley, William Lynn, Helen Burgess, Bobby Mann, Ambreen Imran, Saranya Sridhar, Chuen-Yan Tsou, Vladyslav Nikolayevskyy, Melanie Rees-Roberts, Hilary Whitworth, Onn Min Kon, Pranab Haldar, Heinke Kunst, Sarah Anderson, Andrew Hayward, John M Watson, Heather Milburn, Ajit Lalvani, D Adeboyeku, N Bari, J Barker, H Booth, F Chua, D Creer, M Darmalingam, R N Davidson, M Dedicoat, A Dunleavy, J Figueroa, M Haseldean, N Johnson, S Losewicz, J Lord, J Moore-Gillon, G Packe, M Pareek, S Tiberi, A Pozniak, F Sanderson

DOI
10.1016/s1473-3099(18)30355-4
PMID
30174209
PMCID
PMC6192014
OpenAlex
W2889216817
Study type
Cohort study
Publisher
Elsevier BV
Article type
journal-article
Integrity
current

Why this research matters now

Optimizing diagnostic selection for high-risk demographics may enhance resource allocation by prioritizing individuals with demonstrably higher progression probabilities.

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Structured evidence summary

Research question

The study investigates whether interferon-γ release assays and specific tuberculin skin test cutoffs can accurately forecast the onset of active tuberculosis among individuals at elevated infection risk.

Study design

This prospective cohort design enrolled adults across fifty-four United Kingdom locations, administering three distinct immunological assessments and monitoring outcomes through national databases and direct contact.

Population and setting

The analysis focused on a large sample of recent household contacts and recent international arrivals residing in major British urban areas.

Main findings

Among nearly ten thousand screened individuals, approximately one percent developed active disease over a median follow-up period of twenty-nine months. Negative screening results corresponded to negligible yearly progression rates, whereas positivity on T-SPOT.TB, BCG-stratified skin testing, and QuantiFERON assays yielded markedly higher annual incidence figures relative to conventional five-millimeter or ten-millimeter skin test cutoffs.

Public-health relevance

Optimizing diagnostic selection for high-risk demographics may enhance resource allocation by prioritizing individuals with demonstrably higher progression probabilities.

Important limitations

This assessment is constrained by its dependence on the supplied abstract and bibliographic records, requiring access to the complete publication for thorough methodological scrutiny and decision-grade interpretation.

GIDS interpretation

This publication contributes baseline diagnostic accuracy metrics that may inform literature mapping efforts regarding tuberculosis screening methodologies and risk stratification frameworks.

02

Related GIDS surveillance

Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.

03

Evidence relationships

This article has 11 auditable classifier relationships to diseases, places, topics, and study design.

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