New Tests for the Diagnosis of Latent Tuberculosis Infection
Authors: Heinke Kunst, Khalid S. Khan
Journal: Annals of Internal Medicine (2007)

Letters6 November 2007New Tests for the Diagnosis of Latent Tuberculosis InfectionHeinke Kunst, MBBS, MD, MSC and Khalid S. Khan, MBBS, MSc, MmedHeinke Kunst, MBBS, MD, MSCFrom Birmingham Heartlands Hospital and University of Birmingham, Birmingham B9 5SS; and University of Birmingham, Birmingham B15 2TT, United Kingdom.Search for more papers by this author and Khalid S. Khan, MBBS, MSc, MmedFrom Birmingham Heartlands Hospital and University of Birmingham, Birmingham B9 5SS; and University of Birmingham, Birmingham B15 2TT, United Kingdom.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-147-9-200711060-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We read Menzies and colleagues' meta-analysis of new tests for latent tuberculosis infection (1) with interest and generally concurred with the authors' inferences for research and practice. As the target condition in the review lacks a gold standard, we were dissatisfied with the use of sensitivity and specificity—measures of test accuracy that cannot be computed without verification of disease status—in data synthesis. It is important for researchers to establish the evidence base for incorporation of new tests in clinical practice concerning latent tuberculosis infection by using sound methods for evaluating tests without a gold standard (2), and ...References1. Menzies D, Pai M, Comstock G. Meta-analysis: new tests for the diagnosis of latent tuberculosis infection: areas of uncertainty and recommendations for research. Ann Intern Med. 2007;146:340-54. [PMID: 17339619] LinkGoogle Scholar2. Rutjes AS, Riestma JB, Coomarasamy A, Khan KS, Bossuyt P. Evaluation of diagnostic tests when there is no gold standard—a review of methods. Health Technol Assess. 2007. [Forthcoming]. Google Scholar3. Ledley RS, Lusted LB. Reasoning foundations of medical diagnosis; symbolic logic, probability, and value theory aid our understanding of how physicians reason. Science. 1959;130:9-21. [PMID: 13668531] CrossrefMedlineGoogle Scholar4. Yerushalmy J. Statistical problems in assessing methods of medical diagnosis, with special reference to x-ray techniques. Public Health Rep. 1947;62:1432-49. CrossrefMedlineGoogle Scholar5. Zamora J, Abraira V, Muriel A, Khan K, Coomarasamy A. Meta-DiSc: a software for meta-analysis of test accuracy data. BMC Med Res Methodol. 2006;6:31. [PMID: 16836745] CrossrefMedlineGoogle Scholar6. Ransohoff DF, Feinstein AR. Problems of spectrum and bias in evaluating the efficacy of diagnostic tests. N Engl J Med. 1978;299:926-30. [PMID: 692598] CrossrefMedlineGoogle Scholar7. Dinnes J, Deeks J, Kunst H, Gibson A, Cummins E, Waugh N, et al. A systematic review of rapid diagnostic tests for the detection of tuberculosis infection. Health Technol Assess. 2007;11:1-196. [PMID: 17266837] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Birmingham Heartlands Hospital and University of Birmingham, Birmingham B9 5SS; and University of Birmingham, Birmingham B15 2TT, United Kingdom.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoMeta-analysis: New Tests for the Diagnosis of Latent Tuberculosis Infection: Areas of Uncertainty and Recommendations for Research Dick Menzies , Madhukar Pai , and George Comstock New Tests for the Diagnosis of Latent Tuberculosis Infection Dick Menzies and Madhukar Pai Metrics Cited byResults of five-year systematic screening for latent tuberculosis infection in healthcare workers in Portugal 6 November 2007Volume 147, Issue 9Page: 672-673KeywordsInfectious diseasesInformation storage and retrievalObservational studiesSkin infectionsSkin testsSpecificitySystematic reviewsTouchTuberculinTuberculosis ePublished: 6 November 2007 Issue Published: 6 November 2007 Copyright & PermissionsCopyright © 2007 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...