Table 1– What are the most important outcomes to consider when making decisions on testing and treatment strategies for drug-resistant tuberculosis (TB)?
Outcomes (bracketed outcomes rephrased as the negative)Mean scoreRelative importance
1) Cure (treatment failure)8.7Critical
2) Prompt initiation of appropriate treatment8.3Critical
3) Avoiding the acquisition or amplification of drug resistance8.1Critical
4) Survival (death)7.9Critical
5) Staying disease-free after treatment; sustaining a cure (relapse)7.6Critical
6) Case holding so the TB patient remains adherent to treatment (default or treatment interruption due to non-adherence)7.6Critical
7) Population coverage or access to appropriate treatment of drug-resistant TB7.5Critical
8) Smear or culture conversion during treatment7.4Critical
9) Accelerated detection of drug resistance7.4Critical
10) Avoid unnecessary treatment for MDR-TB7.2Critical
11) Population coverage or access to diagnosis of drug-resistant TB7.1Critical
12) Prevention or interruption of transmission of drug-resistant TB to other people, including other patients and healthcare workers6.9Important but not critical
13) Shortest possible duration of treatment6.7Important but not critical
14) Avoiding toxicity and adverse reactions from TB drugs6.5Important but not critical
15) Cost to patient, including direct medical costs as well as others, such as transportation and lost wages due to disability6.4Important but not critical
16) Resolution of TB signs and symptoms; ability to resume usual life activities6.3Important but not critical
17) Interaction of TB drugs with non-TB medications5.6Important but not critical
18) Cost to the TB programme5.4Important but not critical
  • Members of the Guideline Development Group submitted scores for TB outcomes which they considered to be the most critical when making decisions on drug-resistant TB management. Members were asked to take a societal perspective in rating the outcomes. Rating by relative importance was on an incremental scale, as follows. 1–3 points: not important for making recommendations on choice of testing and treatment strategies for drug-resistant TB (none of the outcomes was scored in this category); 4–6 points: important but not critical for making recommendations on choice of testing and treatment strategies; 7–9 points: critical for making recommendations on choice of testing and treatment strategies. MDR-TB: multidrug-resistant TB.