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• W2078600660 abstract "Evaluations of T-cell assays for diagnosing active Mycobacterium tuberculosis (TB) infection were recently published in the Journal of Infection by Liao et al., Kim et al. and Clark et al. (December 2009). 1 Liao C.H. Chou C.H. Lai C.C. Huang Y.T. Tan C.K. Hsu H.L. et al. Diagnostic performance of an enzyme-linked immunospot assay for interferon-gamma in extrapulmonary tuberculosis varies between different sites of disease. J Infect. 2009; 59: 402-408 Abstract Full Text Full Text PDF PubMed Scopus (65) Google Scholar , 2 Kim S.H. Cho O.H. Park S.J. Ye B.D. Sung H. Kim M.N. et al. Diagnosis of abdominal tuberculosis by T-cell-based assays on peripheral blood and peritoneal fluid mononuclear cells. J Infect. 2009; 59: 409-415 Abstract Full Text Full Text PDF PubMed Scopus (32) Google Scholar These evaluations presented evidence of T-cell assays clinical accuracy, i.e. can the tests detect the presence and absence of active TB infection. Unfortunately, knowledge of T-cell assays clinical accuracy offers only moderate help in deciding if the tests are clinically useful in an individual patient. To better understand clinical usefulness, evaluations should investigate how a patient's management is altered by their use, that is: does the test help you treat the patient quicker, cheaper, or better; does it make no difference or does it lead to harm? At present the debate about T-cell assays for diagnosing active TB infection seems focused on their clinical accuracy. A simple Medline search, based on the term ELISPOT and Tuberculosis, demonstrates this. This search identified seven studies into the clinical accuracy of T-cell assays to diagnose active TB infection. 3 Liebeschuetz S. Bamber S. Ewer K. Deeks J. Pathan A.A. Lalvani A. Diagnosis of tuberculosis in South African children with a T-cell-based assay: a prospective cohort study. Lancet. 2004; 364: 2196-2203 Abstract Full Text Full Text PDF PubMed Scopus (333) Google Scholar , 4 Kim S.H. Song K.H. Choi S.J. Kim H.B. Kim N.J. Oh M.D. et al. Diagnostic usefulness of a T-cell-based assay for extrapulmonary tuberculosis in immunocompromised patients. Am J Med. 2009; 122: 189-195 Abstract Full Text Full Text PDF PubMed Scopus (73) Google Scholar , 5 Lee L.N. Chou C.H. Wang J.Y. Hsu H.L. Tsai T.H. Jan I.S. et al. Enzyme-linked immunospot assay for interferon-gamma in the diagnosis of tuberculous pleurisy. Clin Microbiol Infect. 2009; 15: 173-179 Abstract Full Text Full Text PDF PubMed Scopus (54) Google Scholar , 6 Dosanjh D.P. Hinks T.S. Innes J.A. Deeks J.J. Pasvol G. Hackforth S. et al. Improved diagnostic evaluation of suspected tuberculosis. Ann Intern Med. 2008; 148: 325-336 Crossref PubMed Scopus (132) Google Scholar , 7 Kim S.H. Choi S.J. Kim H.B. Kim N.J. Oh M.D. Choe K.W. Diagnostic usefulness of a T-cell based assay for extrapulmonary tuberculosis. Arch Intern Med. 2007; 167: 2255-2259 Crossref PubMed Scopus (103) Google Scholar , 8 Adetifa I.M. Lugos M.D. Hammond A. Jeffries D. Donkor D. Adegbola R.A. et al. Comparison of two interferon gamma release assays in the diagnosis of Mycobacterium tuberculosis infection and disease in The Gambia. BMC Infect Dis. 2007; 7: 122 Crossref PubMed Scopus (77) Google Scholar Only one reported clinical usefulness. It included just seven patients with active TB, 9 Gooding S. Chowdhury O. Hinks T. Richeldi L. Losi M. Ewer K. et al. Impact of a T cell-based blood test for tuberculosis infection on clinical decision-making in routine practice. J Infect. 2007; 54: 169-174 Abstract Full Text Full Text PDF Scopus (21) Google Scholar with the T-cell assays prompting early initiation of anti-tuberculous therapy in three patients. This provides preliminary evidence that despite the limitations of the T-cell assays: their clinical sensitivity being reported as low as 70% by Liao et al., their clinical usefulness is worthy of investigation." @default.
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• W2078600660 date "2010-03-01" @default.
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• W2078600660 title "Improving evaluations of T-cell assays for diagnosing active Mycobacterium tuberculosis infection" @default.
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• W2078600660 doi "https://doi.org/10.1016/j.jinf.2009.12.006" @default.
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