Controlling tuberculosis in an urban emergency department: a rapid decision instrument for patient isolation.
OBJECTIVE
This study examined whether data routinely available in emergency departments could be used to improve isolation decisions for tuberculosis patients.


METHODS
In a large emergency department in New York City, we compared the exposure histories of tuberculosis culture-positive and culture-negative patients and used these data to develop a rapid decision instrument to predict culture-positive tuberculosis. The screen used only data that are routinely available to emergency physicians.


RESULTS
The method had high sensitivity (.96) and moderate specificity (.54).


CONCLUSIONS
The method is easily adaptable for a broad range of settings and illustrates the potential benefits of applying basic epidemiologic methods in a clinical setting.
Redd
J T
JT
Columbia University School of Public Health, New York, NY, USA.
Susser
E
E
D000328:Adult; D016022:Case-Control Studies; D003661:Decision Support Techniques; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City; D010356:Patient Isolation; D011237:Predictive Value of Tests; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000517:prevention & control*; D019037:Urban Health Services