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Rationing tests for drug-resistant tuberculosis – who are we prepared to miss?

Overview of attention for article published in BMC Medicine, March 2016
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (91st percentile)
  • Good Attention Score compared to outputs of the same age and source (76th percentile)

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1 blog
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31 X users

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Title
Rationing tests for drug-resistant tuberculosis – who are we prepared to miss?
Published in
BMC Medicine, March 2016
DOI 10.1186/s12916-016-0576-8
Pubmed ID
Authors

Laura J. Martin, Martha H. Roper, Louis Grandjean, Robert H. Gilman, Jorge Coronel, Luz Caviedes, Jon S. Friedland, David A. J. Moore

Abstract

Early identification of patients with drug-resistant tuberculosis (DR-TB) increases the likelihood of treatment success and interrupts transmission. Resource-constrained settings use risk profiling to ration the use of drug susceptibility testing (DST). Nevertheless, no studies have yet quantified how many patients with DR-TB this strategy will miss. A total of 1,545 subjects, who presented to Lima health centres with possible TB symptoms, completed a clinic-epidemiological questionnaire and provided sputum samples for TB culture and DST. The proportion of drug resistance in this population was calculated and the data was analysed to demonstrate the effect of rationing tests to patients with multidrug-resistant TB (MDR-TB) risk factors on the number of tests needed and corresponding proportion of missed patients with DR-TB. Overall, 147/1,545 (9.5 %) subjects had culture-positive TB, of which 32 (21.8 %) had DR-TB (MDR, 13.6 %; isoniazid mono-resistant, 7.5 %; rifampicin mono-resistant, 0.7 %). A total of 553 subjects (35.8 %) reported one or more MDR-TB risk factors; of these, 506 (91.5 %; 95 % CI, 88.9-93.7 %) did not have TB, 32/553 (5.8 %; 95 % CI, 3.4-8.1 %) had drug-susceptible TB, and only 15/553 (2.7 %; 95 % CI, 1.5-4.4 %) had DR-TB. Rationing DST to those with an MDR-TB risk factor would have missed more than half of the DR-TB population (17/32, 53.2 %; 95 % CI, 34.7-70.9). Rationing DST based on known MDR-TB risk factors misses an unacceptable proportion of patients with drug-resistance in settings with ongoing DR-TB transmission. Investment in diagnostic services to allow universal DST for people with presumptive TB should be a high priority.

X Demographics

X Demographics

The data shown below were collected from the profiles of 31 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 65 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 65 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 15 23%
Student > Master 10 15%
Student > Postgraduate 7 11%
Student > Bachelor 6 9%
Student > Ph. D. Student 5 8%
Other 10 15%
Unknown 12 18%
Readers by discipline Count As %
Medicine and Dentistry 32 49%
Immunology and Microbiology 6 9%
Nursing and Health Professions 4 6%
Biochemistry, Genetics and Molecular Biology 4 6%
Agricultural and Biological Sciences 3 5%
Other 4 6%
Unknown 12 18%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 24. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 24 October 2023.
All research outputs
#1,520,020
of 24,862,067 outputs
Outputs from BMC Medicine
#1,068
of 3,870 outputs
Outputs of similar age
#25,376
of 306,311 outputs
Outputs of similar age from BMC Medicine
#13
of 52 outputs
Altmetric has tracked 24,862,067 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 93rd percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 3,870 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 45.2. This one has gotten more attention than average, scoring higher than 72% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 306,311 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 91% of its contemporaries.
We're also able to compare this research output to 52 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 76% of its contemporaries.