title: A comparison of interview methods to ascertain fluoroquinolone exposure before tuberculosis diagnosis.
abstract: SUMMARY Fluoroquinolone use before tuberculosis (TB) diagnosis delays the time to diagnosis and treatment, and increases the risk of fluoroquinolone-resistant TB and death. Ascertainment of fluoroquinolone exposure could identify such high-risk patients. We compared four methods of ascertaining fluoroquinolone exposure in the 6 months prior to TB diagnosis in culture-confirmed TB patients in Tennessee from January 2007 to December 2009. The four methods included a simple questionnaire administered to all TB suspects by health department personnel (FQ-Form), an in-home interview conducted by research staff, outpatient and inpatient medical record review, and TennCare pharmacy database review. Of 177 TB patients included, 72 (41%) received fluoroquinolones during the 6 months before TB diagnosis. Fluoroquinolone exposure determined by review of inpatient and outpatient medical records was considered the gold standard for comparison. The FQ-Form had 61% [95% confidence interval (CI) 48-73] sensitivity and 93% (95% CI 85-98) specificity (agreement 79%, kappa = 0.56) while the in-home interview had 28% (95% CI 18-40) sensitivity and 99% (94-100%) specificity (agreement 68%, kappa = 0.29). A simple questionnaire administered by health department personnel identified fluoroquinolone exposure before TB diagnosis with moderate reliability.
authors.affiliation: Division of Infectious Diseases,Department of Medicine,Vanderbilt University School of Medicine,Nashville,TN,USA.
authors.forename: Y F
authors.initials: YF
authors.lastname: Van Der Heijden
authors.affiliation: Division of Infectious Diseases,Department of Medicine,Vanderbilt University School of Medicine,Nashville,TN,USA.
authors.forename: F
authors.initials: F
authors.lastname: Maruri
authors.affiliation: Tennessee Department of Health,Nashville,TN,USA.
authors.forename: E
authors.initials: E
authors.lastname: Holt
authors.affiliation: Department of Health Policy,Vanderbilt University School of Medicine,Nashville,TN,USA.
authors.forename: E
authors.initials: E
authors.lastname: Mitchel
authors.affiliation: Tennessee Department of Health,Nashville,TN,USA.
authors.forename: J
authors.initials: J
authors.lastname: Warkentin
authors.affiliation: Division of Infectious Diseases,Department of Medicine,Vanderbilt University School of Medicine,Nashville,TN,USA.
authors.forename: T R
authors.initials: TR
authors.lastname: Sterling
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016208:Databases, Factual; D057210:Delayed Diagnosis; D024881:Drug Resistance, Bacterial; D005260:Female; D024841:Fluoroquinolones / Q000008:administration & dosage*; D006801:Humans; D007407:Interviews as Topic / Q000379:methods*; D008297:Male; D008487:Medical History Taking / Q000379:methods*; D008499:Medical Records; D008875:Middle Aged; D010594:Pharmacies; D011795:Surveys and Questionnaires; D013714:Tennessee; D014376:Tuberculosis / Q000175:diagnosis; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis*
chemical_list: D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones
keywords: tuberculosis (TB)