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The interpretation of nucleic acid amplification tests for tuberculosis: do rapid tests change treatment decisions?

Conaty, SJ; Claxton, AP; Enoch, DA; Hayward, AC; Lipman, MCI; Gillespie, SH; (2005) The interpretation of nucleic acid amplification tests for tuberculosis: do rapid tests change treatment decisions? J INFECTION , 50 (3) 187 - 192. 10.1016/j.jinf.2004.03.010.

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Abstract

Objectives. To describe changes in treatment decisions after receipt of nucleic acid amplification (NAA) test for the diagnosis of A tuberculosis.Methods. Retrospective notes review of treatment decisions in patients receiving a NAA test for suspected pulmonary or non-pulmonary tuberculosis at the Royal Free Hospital in London between March 2001 and February 2002. Notes were sought on a 50% random sample of patients with both smear and NAA negative specimens and at patients with other specimen results.Results. Two hundred and fifty patients were tested with NAA; clinical details were obtained on 138; 61 were ever treated. Seventeen (17/18) smear-negative patients were started on treatment after a positive NAA; none of six smear-negative patients treated prior to a negative NAA result had treatment stopped. Seventeen (17/21) smear-positive patients were treated prior to NAA result and all were NAA positive; treatment was delayed in four smear-positive patients until receipt of an NAA and one NAA-negative patient was not treated.Conclusions. In routine practice a positive test in an untreated smear-negative patient leads to decision to treat in almost all, but the proportion testing positive is low (8% or 17/219). In patients already on treatment negative tests did not lead to decisions to stop. (c) 2004 The British Infection Society. Published by Elsevier Ltd. All rights reserved.

Type: Article
Title: The interpretation of nucleic acid amplification tests for tuberculosis: do rapid tests change treatment decisions?
DOI: 10.1016/j.jinf.2004.03.010
Keywords: tuberculosis, tuberculosis/diagnosis, nucleic acid amplification techniques, sensitivity and specificity, predictive value of tests, MYCOBACTERIUM-TUBERCULOSIS, PULMONARY TUBERCULOSIS, LABORATORY DIAGNOSIS, MOLECULAR DIAGNOSIS
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Respiratory Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Epidemiology and Health > Primary Care and Population Health
URI: http://discovery.ucl.ac.uk/id/eprint/324
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