Delineating a Retesting Zone Using Receiver Operating Characteristic Analysis on Serial QuantiFERON Tuberculosis Test Results in US Healthcare Workers
Objective. To find a statistically significant separation point for the QuantiFERON Gold In-Tube (QFT) interferon gamma release assay that could define an optimal “retesting zone” for use in serially tested low-risk populations who have test “reversions” from initially positive to subsequently negat...
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doaj-44cbf23ba20f4cd98fb8d0b27d1fe0982020-11-24T22:40:41ZengHindawi LimitedPulmonary Medicine2090-18362090-18442012-01-01201210.1155/2012/291294291294Delineating a Retesting Zone Using Receiver Operating Characteristic Analysis on Serial QuantiFERON Tuberculosis Test Results in US Healthcare WorkersWendy Thanassi0Art Noda1Beatriz Hernandez2Jeffery Newell3Paul Terpeluk4David Marder5Jerome A. Yesavage6Department of Medicine, Veterans Affairs Palo Alto Health Care System, 3801 Miranda Avenue MC-, Palo Alto, CA 94304-1207, USAWar Related Illness and Injury Study Center (WRIISC) and Mental Illness Research Education and Clinical Center (MIRECC), Department of Veterans Affairs, Palo Alto, CA 94304, USAWar Related Illness and Injury Study Center (WRIISC) and Mental Illness Research Education and Clinical Center (MIRECC), Department of Veterans Affairs, Palo Alto, CA 94304, USAWar Related Illness and Injury Study Center (WRIISC) and Mental Illness Research Education and Clinical Center (MIRECC), Department of Veterans Affairs, Palo Alto, CA 94304, USADepartment of Occupational Health, The Cleveland Clinic, Cleveland, OH 44195, USAUniversity Health Services, University of Illinois Chicago, Chicago, IL 60612, USAWar Related Illness and Injury Study Center (WRIISC) and Mental Illness Research Education and Clinical Center (MIRECC), Department of Veterans Affairs, Palo Alto, CA 94304, USAObjective. To find a statistically significant separation point for the QuantiFERON Gold In-Tube (QFT) interferon gamma release assay that could define an optimal “retesting zone” for use in serially tested low-risk populations who have test “reversions” from initially positive to subsequently negative results. Method. Using receiver operating characteristic analysis (ROC) to analyze retrospective data collected from 3 major hospitals, we searched for predictors of reversion until statistically significant separation points were revealed. A confirmatory regression analysis was performed on an additional sample. Results. In 575 initially positive US healthcare workers (HCWs), 300 (52.2%) had reversions, while 275 (47.8%) had two sequential positive tests. The most statistically significant (Kappa = 0.48, chi-square = 131.0, P<0.001) separation point identified by the ROC for predicting reversion was the tuberculosis antigen minus-nil (TBag-nil) value at 1.11 International Units per milliliter (IU/mL). The second separation point was found at TBag-nil at 0.72 IU/mL (Kappa = 0.16, chi-square = 8.2, P<0.01). The model was validated by the regression analysis of 287 HCWs. Conclusion. Reversion likelihood increases as the TBag-nil approaches the manufacturer's cut-point of 0.35 IU/mL. The most statistically significant separation point between those who test repeatedly positive and those who revert is 1.11 IU/mL. Clinicians should retest low-risk individuals with initial QFT results < 1.11 IU/mL.http://dx.doi.org/10.1155/2012/291294 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Wendy Thanassi Art Noda Beatriz Hernandez Jeffery Newell Paul Terpeluk David Marder Jerome A. Yesavage |
spellingShingle |
Wendy Thanassi Art Noda Beatriz Hernandez Jeffery Newell Paul Terpeluk David Marder Jerome A. Yesavage Delineating a Retesting Zone Using Receiver Operating Characteristic Analysis on Serial QuantiFERON Tuberculosis Test Results in US Healthcare Workers Pulmonary Medicine |
author_facet |
Wendy Thanassi Art Noda Beatriz Hernandez Jeffery Newell Paul Terpeluk David Marder Jerome A. Yesavage |
author_sort |
Wendy Thanassi |
title |
Delineating a Retesting Zone Using Receiver Operating Characteristic Analysis on Serial QuantiFERON Tuberculosis Test Results in US Healthcare Workers |
title_short |
Delineating a Retesting Zone Using Receiver Operating Characteristic Analysis on Serial QuantiFERON Tuberculosis Test Results in US Healthcare Workers |
title_full |
Delineating a Retesting Zone Using Receiver Operating Characteristic Analysis on Serial QuantiFERON Tuberculosis Test Results in US Healthcare Workers |
title_fullStr |
Delineating a Retesting Zone Using Receiver Operating Characteristic Analysis on Serial QuantiFERON Tuberculosis Test Results in US Healthcare Workers |
title_full_unstemmed |
Delineating a Retesting Zone Using Receiver Operating Characteristic Analysis on Serial QuantiFERON Tuberculosis Test Results in US Healthcare Workers |
title_sort |
delineating a retesting zone using receiver operating characteristic analysis on serial quantiferon tuberculosis test results in us healthcare workers |
publisher |
Hindawi Limited |
series |
Pulmonary Medicine |
issn |
2090-1836 2090-1844 |
publishDate |
2012-01-01 |
description |
Objective. To find a statistically significant separation point for the QuantiFERON Gold In-Tube (QFT) interferon gamma release assay that could define an optimal “retesting zone” for use in serially tested low-risk populations who have test “reversions” from initially positive to subsequently negative results. Method. Using receiver operating characteristic analysis (ROC) to analyze retrospective data collected from 3 major hospitals, we searched for predictors of reversion until statistically significant separation points were revealed. A confirmatory regression analysis was performed on an additional sample. Results. In 575 initially positive US healthcare workers (HCWs), 300 (52.2%) had reversions, while 275 (47.8%) had two sequential positive tests. The most statistically significant (Kappa = 0.48, chi-square = 131.0, P<0.001) separation point identified by the ROC for predicting reversion was the tuberculosis antigen minus-nil (TBag-nil) value at 1.11 International Units per milliliter (IU/mL). The second separation point was found at TBag-nil at 0.72 IU/mL (Kappa = 0.16, chi-square = 8.2, P<0.01). The model was validated by the regression analysis of 287 HCWs. Conclusion. Reversion likelihood increases as the TBag-nil approaches the manufacturer's cut-point of 0.35 IU/mL. The most statistically significant separation point between those who test repeatedly positive and those who revert is 1.11 IU/mL. Clinicians should retest low-risk individuals with initial QFT results < 1.11 IU/mL. |
url |
http://dx.doi.org/10.1155/2012/291294 |
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