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New Tests for the Diagnosis of Latent Tuberculosis Infection
- Heinke Kunst, MBBS, MD, MSC; and
- Khalid S. Khan, MBBS, MSc, Mmed
- From Birmingham Heartlands Hospital and University of Birmingham, Birmingham B9 5SS; and University of Birmingham, Birmingham B15 2TT, United Kingdom.
TO THE EDITOR:
We read Menzies and colleagues' meta-analysis of new tests for latent tuberculosis infection (1) with interest and generally concurred with the authors' inferences for research and practice. As the target condition in the review lacks a gold standard, we were dissatisfied with the use of sensitivity and specificity—measures of test accuracy that cannot be computed without verification of disease status—in data synthesis. It is important for researchers to establish the evidence base for incorporation of new tests in clinical practice concerning latent tuberculosis infection by using sound methods for evaluating tests without a gold standard (2), and we would like to highlight some key issues important for such research.
Half a century ago, sensitivity and specificity were introduced to express diagnostic accuracy (3, 4) in studies where findings of medical tests were compared between patients known to have the …
