What diagnostic utility do chest X-ray findings have for diagnosing TB?”

Go to Dynamed and search: Active tuberculosis

Select Diagnosis > Clinical Prediction Rules

chest x-ray scoring systems may have high sensitivity but low specificity for diagnosing active pulmonary TB (level 2 [mid-level] evidence)
-based on systematic review of diagnostic studies with reference standard not applied to all patients
-systematic review of 13 diagnostic studies evaluating scoring systems using chest x-rays and clinical factors for -active pulmonary TB in 6,112 patients
-reference standard was liquid or solid culture
-all studies had possible partial verification bias due to selective application of reference standard
-radiographic features significantly associated with pulmonary TB included
-upper lobe infiltrates in analysis of 5 studies
-cavities in analysis of 3 studies
-diagnostic performance of chest x-ray scoring systems for diagnosis of pulmonary TB
-in all patients with possible pulmonary TB in 6 studies with 3,800 patients
-sensitivity range 81%-100%
-specificity range 22%-72%
-in patients with negative sputum smear in 5 studies with 1,687 patients
-sensitivity range 93%-98%
-specificity range 14%-50%

Also for more information refer to:

Pinto, Lancelot M, et al. “Scoring systems using chest radiographic features for the diagnosis of pulmonary tuberculosis in adults: a systematic review.” The European respiratory journal 42.2 (2013):480-494.

Chest radiography for the diagnosis of active pulmonary tuberculosis is limited by poor specificity and reader inconsistency. Scoring systems have been employed successfully for improving the performance of chest radiography for various pulmonary diseases. We conducted a systematic review to assess the diagnostic accuracy and reproducibility of scoring systems for PTB.

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