Test | Chest radiography | Microbiological | Amplification | Immunological | ||||
Smear | Single culture | Three cultures | PCR | TST | Serology | Cell-mediated immunity test | ||
Sensitivity % [ref.] | ||||||||
Pulmonary TB overall | 59–82 35, 40, 42–44 | 50–80 28, 46 | 80–85 28, 46 | 80–100 28, 46 | 50–95 49–52 | 53–90 53 | 21–90 54 | 53–77 55, 56 |
Smear positive | 80 35, 40, 42–44 | 100 28, 46 | 85–96 28, 46 | 90–100 28, 46 | 95 49–51 | 53–73 57, 58 | 45–96 52, 59–61 | |
Smear negative | 60 35, 40, 42–44 | 0 | 50 28, 46 | 80 28, 46 | 48–53 49–52 | 90 52 | 16–97 52, 59–61 | |
Specificity % [ref.] | 52–99 35, 40, 42–44 | 95 28, 46 | 98 47 | 98 47 | 98 49–52 | 5¶ 53 | 80–100 54 | 64–100 55, 56 |
Positive predictive value# % | 2.9 | 11.6 | 29.3 | 31.3 | 26.9 | <1 | 5.2 | 3.5 |
TST: tuberculin skin test. #: calculated for 1% prevalence of active TB, using the mid-point of the range of sensitivity and specificity for each test; ¶: the specificity of positive TST is to distinguish active TB disease from latent TB infection.