Twelve Hour Observation Unit Diagnosis of Tuberculosis. Abstract, ExecutiveSummary and Final Report

摘要

Objectives: To compare the sensitivity, specificity, positive predictive valueand negative predictive value of direct microscopic detection of AFB when performed on 3 serial sputum samples obtained within 12 hours in an Emergency Department Observation Unit (EDOU) versus 3 early morning sputum samples obtained during consecutive hospital days. To determine the accuracy of a standardized clinical assessment obtained in the ED that considers patient history, risk factors, physical exam and chest radiograph at presentation in predicting the diagnosis of active pulmonary tuberculosis (TB). To compare the sensitivity and specificity of the diagnosis of TB in the EDOU vs. in-patient isolation unit (IPIU), assessing the diagnostic capability of the EDOU as a rapid identifier of new tuberculosis cases, allowing more precise indications for hospitalization and the use of respiratory isolation beds. Study Design: Prospective, cross-sectional analysis of a multi-stage diagnostic test evaluation. Setting: Municipal inner-city hospital emergency department. Participants: Eighty-seven patients, aged 16-87, admitted to an isolation bed with possible active TB.