title: Evaluation of tuberculosis diagnostics in children: 1. Proposed clinical case definitions for classification of intrathoracic tuberculosis disease. Consensus from an expert panel.
abstract: There is a critical need for improved diagnosis of tuberculosis in children, particularly in young children with intrathoracic disease as this represents the most common type of tuberculosis in children and the greatest diagnostic challenge. There is also a need for standardized clinical case definitions for the evaluation of diagnostics in prospective clinical research studies that include children in whom tuberculosis is suspected but not confirmed by culture of Mycobacterium tuberculosis. A panel representing a wide range of expertise and child tuberculosis research experience aimed to develop standardized clinical research case definitions for intrathoracic tuberculosis in children to enable harmonized evaluation of new tuberculosis diagnostic technologies in pediatric populations. Draft definitions and statements were proposed and circulated widely for feedback. An expert panel then considered each of the proposed definitions and statements relating to clinical definitions. Formal group consensus rules were established and consensus was reached for each statement. The definitions presented in this article are intended for use in clinical research to evaluate diagnostic assays and not for individual patient diagnosis or treatment decisions. A complementary article addresses methodological issues to consider for research of diagnostics in children with suspected tuberculosis.
authors.affiliation: Centre for International Child Health, University of Melbourne Department of Paediatrics and Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Australia. steve.graham@rch.org.au
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Graham
authors.forename: Tahmeed
authors.initials: T
authors.lastname: Ahmed
authors.forename: Farhana
authors.initials: F
authors.lastname: Amanullah
authors.forename: Renee
authors.initials: R
authors.lastname: Browning
authors.forename: Vicky
authors.initials: V
authors.lastname: Cardenas
authors.forename: Martina
authors.initials: M
authors.lastname: Casenghi
authors.forename: Luis E
authors.initials: LE
authors.lastname: Cuevas
authors.forename: Marianne
authors.initials: M
authors.lastname: Gale
authors.forename: Robert P
authors.initials: RP
authors.lastname: Gie
authors.forename: Malgosia
authors.initials: M
authors.lastname: Grzemska
authors.forename: Ed
authors.initials: E
authors.lastname: Handelsman
authors.forename: Mark
authors.initials: M
authors.lastname: Hatherill
authors.forename: Anneke C
authors.initials: AC
authors.lastname: Hesseling
authors.forename: Patrick
authors.initials: P
authors.lastname: Jean-Philippe
authors.forename: Beate
authors.initials: B
authors.lastname: Kampmann
authors.forename: Sushil Kumar
authors.initials: SK
authors.lastname: Kabra
authors.forename: Christian
authors.initials: C
authors.lastname: Lienhardt
authors.forename: Jennifer
authors.initials: J
authors.lastname: Lighter-Fisher
authors.forename: Shabir
authors.initials: S
authors.lastname: Madhi
authors.forename: Mamodikoe
authors.initials: M
authors.lastname: Makhene
authors.forename: Ben J
authors.initials: BJ
authors.lastname: Marais
authors.forename: David F
authors.initials: DF
authors.lastname: McNeeley
authors.forename: Heather
authors.initials: H
authors.lastname: Menzies
authors.forename: Charles
authors.initials: C
authors.lastname: Mitchell
authors.forename: Surbhi
authors.initials: S
authors.lastname: Modi
authors.forename: Lynne
authors.initials: L
authors.lastname: Mofenson
authors.forename: Philippa
authors.initials: P
authors.lastname: Musoke
authors.forename: Sharon
authors.initials: S
authors.lastname: Nachman
authors.forename: Clydette
authors.initials: C
authors.lastname: Powell
authors.forename: Mona
authors.initials: M
authors.lastname: Rigaud
authors.forename: Vanessa
authors.initials: V
authors.lastname: Rouzier
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Starke
authors.forename: Soumya
authors.initials: S
authors.lastname: Swaminathan
authors.forename: Claire
authors.initials: C
authors.lastname: Wingfield
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000995:Antitubercular Agents / Q000627:therapeutic use; D001431:Bacteriological Techniques / Q000379:methods; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D011859:Radiography; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy
chemical_list: D000995:Antitubercular Agents