Measuring the accuracy of a point system to diagnose tuberculosis in children with a negative smear or with no smear or culture

Constantino Giovani Braga Cartaxo; Laura C. Rodrigues; Carolina Pinheiro Braga; Ricardo Arraes de Alencar Ximenes

doi:10.1016/j.jegh.2013.10.002

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Volume 4, Issue 1, March 2014, Pages 29 - 34

Measuring the accuracy of a point system to diagnose tuberculosis in children with a negative smear or with no smear or culture

Authors

Constantino Giovani Braga Cartaxo^a^,constancartaxo@gmail.com, Laura C. Rodrigues^b^,laura.rodrigues@lshtm.ac.uk, Carolina Pinheiro Braga^a^,carolinapbraga@gmail.com, Ricardo Arraes de Alencar Ximenes^c^{, *}^,ricardo.ximenes@pq.cnpq.br

^aDepartamento Materno-Infantil, Universidade Federal da Paraiba, Brazil

^bFaculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, United Kingdom

^cDepartamento de Medicina Tropical, Universidade Federal de Pernambuco, Brazil

^*Corresponding author.

Corresponding Author

Ricardo Arraes de Alencar Ximenesricardo.ximenes@pq.cnpq.br

Received 11 December 2012, Revised 30 September 2013, Accepted 7 October 2013, Available Online 15 November 2013.

DOI: 10.1016/j.jegh.2013.10.002 How to use a DOI?
Keywords: Tuberculosis; Childhood; Scoring system; Validation study
Abstract: In Brazil, a scoring system was adopted to diagnose tuberculosis in childhood. This study determined the accuracy in diagnosing tuberculosis in children with either a negative smear or with no smear or culture conducted in a reference center in João Pessoa Paraíba – Brazil. It is a phase III validation study, using a cross-section design. The study population consisted of 167 patients attending the outpatient clinics suspected of having tuberculosis. The reference standard for the diagnosis of tuberculosis was a blind and independent review of the medical records, radiology and tuberculin test by two experts. Of the 167 patients, 60 were considered to have tuberculosis (by the reference standard diagnostics). The results for the scoring system with the cut-off of 30 points were: sensitivity 78.57% (95%-CI: 65.56–88.41%), specificity 69.16% (95%-CI: 59.50–77.73%), positive predictive value (PPV): 57.14% (95%-CI: 45.35–68.37%), negative predictive value (NPV): 86.05% (95%-CI: 76.89–92.58%), likelihood ratio (+): 2,55, pre-test probability: 34.36%, and post-test probability (+): 57.14%. This supports the current recommendation for the use of this scoring system in Brazil and similar sites with the cut-off of 30 points. However, as the discriminatory power of the point scoring system may vary across settings, it would be advisable to replicate this phase III study in different settings.
Open Access: This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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Journal: Journal of Epidemiology and Global Health
Volume-Issue: 4 - 1
Pages: 29 - 34
Publication Date: 2013/11/15
ISSN (Online): 2210-6014
ISSN (Print): 2210-6006
DOI: 10.1016/j.jegh.2013.10.002 How to use a DOI?
Open Access: This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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ris enw bib

TY  - JOUR
AU  - Constantino Giovani Braga Cartaxo
AU  - Laura C. Rodrigues
AU  - Carolina Pinheiro Braga
AU  - Ricardo Arraes de Alencar Ximenes
PY  - 2013
DA  - 2013/11/15
TI  - Measuring the accuracy of a point system to diagnose tuberculosis in children with a negative smear or with no smear or culture
JO  - Journal of Epidemiology and Global Health
SP  - 29
EP  - 34
VL  - 4
IS  - 1
SN  - 2210-6014
UR  - https://doi.org/10.1016/j.jegh.2013.10.002
DO  - 10.1016/j.jegh.2013.10.002
ID  - BragaCartaxo2013
ER  -

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