title: Rapid diagnostic algorithms as a screening tool for tuberculosis: an assessor blinded cross-sectional study.
abstract: BACKGROUND
  A major obstacle to effectively treat and control tuberculosis is the absence of an accurate, rapid, and low-cost diagnostic tool. A new approach for the screening of patients for tuberculosis is the use of rapid diagnostic classification algorithms.
  
  
  METHODS
  We tested a previously published diagnostic algorithm based on four biomarkers as a screening tool for tuberculosis in a Central European patient population using an assessor-blinded cross-sectional study design. In addition, we developed an improved diagnostic classification algorithm based on a study population at a tertiary hospital in Vienna, Austria, by supervised computational statistics.
  
  
  RESULTS
  The diagnostic accuracy of the previously published diagnostic algorithm for our patient population consisting of 206 patients was 54% (CI: 47%-61%). An improved model was constructed using inflammation parameters and clinical information. A diagnostic accuracy of 86% (CI: 80%-90%) was demonstrated by 10-fold cross validation. An alternative model relying solely on clinical parameters exhibited a diagnostic accuracy of 85% (CI: 79%-89%).
  
  
  CONCLUSIONS
  Here we show that a rapid diagnostic algorithm based on clinical parameters is only slightly improved by inclusion of inflammation markers in our cohort. Our results also emphasize the need for validation of new diagnostic algorithms in different settings and patient populations.
authors.affiliation: Division of Infectious Diseases and Tropical Medicine, Department of Medicine I, Medical University Vienna, Vienna, Austria.
authors.forename: Franz
authors.initials: F
authors.lastname: Ratzinger
authors.forename: Harald
authors.initials: H
authors.lastname: Bruckschwaiger
authors.forename: Martin
authors.initials: M
authors.lastname: Wischenbart
authors.forename: Bernhard
authors.initials: B
authors.lastname: Parschalk
authors.forename: Delmiro
authors.initials: D
authors.lastname: Fernandez-Reyes
authors.forename: Heimo
authors.initials: H
authors.lastname: Lagler
authors.forename: Alexandra
authors.initials: A
authors.lastname: Indra
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Graninger
authors.forename: Stefan
authors.initials: S
authors.lastname: Winkler
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Krishna
authors.forename: Michael
authors.initials: M
authors.lastname: Ramharter
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D001185:Artificial Intelligence; D015415:Biomarkers / Q000378:metabolism; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007249:Inflammation; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D015203:Reproducibility of Results; D014376:Tuberculosis / Q000145:classification* / Q000175:diagnosis*
chemical_list: D015415:Biomarkers