Table 1– Characteristics of the included studies
StudyCountrySettingEligible patients with possible PTB n (%)Study designInclusion criteriaChest radiograph reader
Studies that included all patients with possible TB
Bock et al. [20], 1996USAInpatient295 (78)Cross-sectional, retrospectivePatients with active TB, Patients with TB in the differential diagnosis, AFB smears and cultures ordered, HIV positive with abnormal CXRRadiologist
El-solh et al. [21], 1997USAInpatient286 (100)Cross-sectionalAll isolated patients, based on symptoms, prior history of TB exposure, HIV status, medical and social risk factors, and radiographic findingsRadiologist and pulmonologist
El-solh et al. [22], 1999USAInpatient119 (100)Cross-sectionalAll patients in whom AFB smear and culture were requestedRadiologist and pulmonologist
Moran et al. [23], 2009USAInpatient2535 (91)Cross-sectionalAdmission diagnosis of pneumonia or suspected TBEmergency medicine resident
Mylotte et al. [24], 1997USAInpatient220 (100)Cross-sectionalAll patients in whom an AFB smear and culture was requested by the admitting physicianNot reported
Solari et al. [25], 2008PeruInpatient345 (71)Cross-sectionalProductive cough for >1 week or cough of any duration and: fever >3 weeks or weight loss of at least 3 kg in the previous month or night sweats or haemoptysis or differential diagnosis of PTB from attending physicianInternist, internal medicine resident
Studies that only included smear-negative patients with possible PTB
Lagrange-Xélot et al. [26], 2010FranceInpatient134 (100)Cross-sectionalSuspected TB, as recommended by French guidelinesNot reported
Soto et al. [27], 2008PeruInpatient262 (100)Cross-sectionalCough ≥1 week and one or more of the following: fever, weight loss ≥4 kg in 1 month, breathlessness, constitutional symptoms (malaise or hyporexia for a minimum of 2 months)Not reported
Soto et al. [28], 2011PeruOutpatient663 (97)Cross-sectionalCough ≥2 weeks and one or more of the following: fever, weight loss, breathlessness1) General practitioner, 2) TB specialist, tie breaker: experienced radiologist
Wisnivesky et al. [30], 2000USAInpatient112 (100)Case–controlCases: isolated TB patients. Controls: randomly selected from a log of patients who submitted smears and cultures matched on age (±3 years), sex and year of presentation, three smears negative, culture negative and isolated in a hospital1) Radiologist 2) Radiologist
Wisnivesky et al. [29], 2005USAInpatient516 (100)Cross-sectionalPatients admitted and isolated because of suspicion of PTBNot reported
Study that included only HIV-uninfected patients with possible PTB
Rakoczy et al. [31], 2008USAInpatient280 (100)Case–controlCases: all TB inpatients. Controls: all inpatients placed under airborne precautions with negative smears and cultures matched with cases on time of admission (±6 days)Not reported
Study that validated six of the scoring systems described above
Solari et al. [32], 2011#PeruInpatient345 (71)Cross-sectionalProductive cough for >1 week or cough of any duration and: fever >3 weeks or weight loss of at least 3 kg in the previous month or night sweats or haemoptysis or differential diagnosis of PTB from attending physicianInternist, internal medicine resident
  • PTB: pulmonary TB; TB: tuberculosis; AFB: acid-fast bacilli; CXR: chest radiograph. #: The study by Solari et al. [32] applied various scoring systems to the same cohort of patients as the study by Solari et al. [25];: Studies had derivation and validation cohorts. The number of patients with possible TB represents those in the validation cohorts.