title: Clinical diagnosis of tuberculosis by specialists and non-specialists.
abstract: In resource-limited settings, tuberculosis (TB) is often diagnosed by non-physicians using the acid-fast bacilli (AFB) smear only. This study examines the diagnostic accuracy of various clinicians using patient-risk history, radiography and AFB smear. A total of 321 physicians, nurses and medical students evaluated 22 profiles of TB suspects and quantified their clinical suspicion (1-99%). Culture results determined diagnostic accuracy. Overall, high-level physician training may not be required; nurses working on TB, given radiograph readings, were as accurate as TB physicians and more accurate than other physicians and clinicians. By considering clinical findings with smear results, TB specialists were significantly more accurate than smear results alone.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, University of California, San Diego, California, USA.
authors.forename: P K
authors.initials: PK
authors.lastname: Lam
authors.forename: P A
authors.initials: PA
authors.lastname: Lobue
authors.forename: A
authors.initials: A
authors.lastname: Catanzaro
mesh_terms: D001431:Bacteriological Techniques / Q000592:standards*; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging / Q000592:standards*; D006801:Humans; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D011361:Professional Competence; D015203:Reproducibility of Results; D014376:Tuberculosis / Q000175:diagnosis*