Accuracy of Timika X-ray scoring system to predict the treatment outcomes among tuberculosis patients in India.


Journal

The Indian journal of tuberculosis
ISSN: 0019-5707
Titre abrégé: Indian J Tuberc
Pays: India
ID NLM: 0373027

Informations de publication

Date de publication:
Oct 2022
Historique:
received: 18 09 2020
accepted: 04 08 2021
entrez: 2 12 2022
pubmed: 3 12 2022
medline: 7 12 2022
Statut: ppublish

Résumé

Timika scoring system is a radiographic grading tool, widely employed for grading the severity of tuberculosis (TB). We evaluated the predictive accuracy of this tool for adverse treatment outcomes among TB patients in Indian setting. We undertook a longitudinal analysis of cohort data under the RePORT-India consortium. Cohort having participants with active pulmonary TB were included. CXRs were independently scored by chest physicians. Timika scoring system had a total score of 140. The predictive nature of the tool was assessed using the ROC analysis. Around 364 laboratory confirmed TB patients were enrolled. The mean (SD) of overall Timika score was 62.3 (24.9). Sputum conversion was achieved among 218/260 (83.8%) patients available at end of intensive phase. AUC for Timika score was 0.53 (95% CI: 0.43-0.63) and for percent lung affected, was 0.56 (95% CI: 0.46-0.65). Unfavorable treatment outcome was observed among 67/287 (23.3%) at the end of continuation phase. AUC for percent lung affected was 0.62 (95% CI: 0.54-0.70) and for Timika score was 0.59 (95% CI: 0.51-0.67). Both Timika scoring system and percent lung affected had poor predictive accuracy, highlighting the inability of a single CXR scoring system to predict the treatment outcome in Indian setting.

Sections du résumé

BACKGROUND BACKGROUND
Timika scoring system is a radiographic grading tool, widely employed for grading the severity of tuberculosis (TB). We evaluated the predictive accuracy of this tool for adverse treatment outcomes among TB patients in Indian setting.
METHODS METHODS
We undertook a longitudinal analysis of cohort data under the RePORT-India consortium. Cohort having participants with active pulmonary TB were included. CXRs were independently scored by chest physicians. Timika scoring system had a total score of 140. The predictive nature of the tool was assessed using the ROC analysis.
RESULTS RESULTS
Around 364 laboratory confirmed TB patients were enrolled. The mean (SD) of overall Timika score was 62.3 (24.9). Sputum conversion was achieved among 218/260 (83.8%) patients available at end of intensive phase. AUC for Timika score was 0.53 (95% CI: 0.43-0.63) and for percent lung affected, was 0.56 (95% CI: 0.46-0.65). Unfavorable treatment outcome was observed among 67/287 (23.3%) at the end of continuation phase. AUC for percent lung affected was 0.62 (95% CI: 0.54-0.70) and for Timika score was 0.59 (95% CI: 0.51-0.67).
CONCLUSION CONCLUSIONS
Both Timika scoring system and percent lung affected had poor predictive accuracy, highlighting the inability of a single CXR scoring system to predict the treatment outcome in Indian setting.

Identifiants

pubmed: 36460379
pii: S0019-5707(21)00146-3
doi: 10.1016/j.ijtb.2021.08.004
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

476-481

Informations de copyright

Copyright © 2021 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Conflicts of interest The authors have none to declare.

Auteurs

Yuvaraj Krishnamoorthy (Y)

Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India. Electronic address: yuvi.1130@gmail.com.

Selby Knudsen (S)

Department of Medicine, Section of Infectious Diseases, Boston University School of Medicine, Boston, MA, USA.

Sathish Rajaa (S)

Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.

Subitha Lakshminarayanan (S)

Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.

P B Senbagavalli (PB)

Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.

Jerrold Ellner (J)

Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA.

Charles Horsburgh (C)

Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.

Natasha Hochberg (N)

Department of Medicine, Section of Infectious Diseases, Boston University School of Medicine, Boston, MA, USA.

Padmini Salgame (P)

Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA.

Sonali Sarkar (S)

Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.

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