Before the whistle blows: developing new paradigms in tuberculosis screening to maximise benefit and minimise harm [version 1; peer review: 1 approved, 1 approved with reservations]. MacPherson, P., Williams, C. M, Burke, R. M, Barer, M. R, & Esmail, H. Wellcome Open Research, 6:8, F1000 Research Limited, jan, 2021.
Before the whistle blows: developing new paradigms in tuberculosis screening to maximise benefit and minimise harm [version 1; peer review: 1 approved, 1 approved with reservations] [link]Paper  doi  abstract   bibtex   
We summarise recent emerging evidence around tuberculosis (TB) transmission and its role in tuberculosis epidemiology, and in novel TB screening and diagnostic tests that will likely become available in low-resource settings in the near future. Little consideration has been paid to how these novel new tests will be implemented, nor what the consequences for individuals, communities and health systems will be. In particular, because of low specificity and consequent false-positive diagnoses, and the low percentage of people who “screen positive” that will go onto develop active pulmonary disease, there is significant potential for inappropriate initiation of TB treatment, as well as stigmatisation, loss of livelihoods and in some setting institutionalisation, with uncertain benefit for individual health or community transmission.
@article{MacPherson2021,
abstract = {We summarise recent emerging evidence around tuberculosis (TB) transmission and its role in tuberculosis epidemiology, and in novel TB screening and diagnostic tests that will likely become available in low-resource settings in the near future. Little consideration has been paid to how these novel new tests will be implemented, nor what the consequences for individuals, communities and health systems will be. In particular, because of low specificity and consequent false-positive diagnoses, and the low percentage of people who “screen positive” that will go onto develop active pulmonary disease, there is significant potential for inappropriate initiation of TB treatment, as well as stigmatisation, loss of livelihoods and in some setting institutionalisation, with uncertain benefit for individual health or community transmission.},
author = {MacPherson, Peter and Williams, Caroline M and Burke, Rachael M and Barer, Michael R and Esmail, Hanif},
doi = {10.12688/wellcomeopenres.16506.1},
file = {:C$\backslash$:/Users/01462563/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/MacPherson et al. - 2021 - Before the whistle blows developing new paradigms in tuberculosis screening to maximise benefit and minimise.pdf:pdf},
issn = {2398-502X},
journal = {Wellcome Open Research},
keywords = {OA,diagnostics,epidemiology,fund{\_}not{\_}ack,letter,transmission,tuberculosis},
mendeley-tags = {OA,fund{\_}not{\_}ack,letter},
month = {jan},
pages = {8},
publisher = {F1000 Research Limited},
title = {{Before the whistle blows: developing new paradigms in tuberculosis screening to maximise benefit and minimise harm [version 1; peer review: 1 approved, 1 approved with reservations]}},
url = {https://wellcomeopenresearch.org/articles/6-8/v1},
volume = {6},
year = {2021}
}

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