{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T16:48:16Z","timestamp":1784566096611,"version":"3.55.0"},"reference-count":96,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2011,9,1]],"date-time":"2011-09-01T00:00:00Z","timestamp":1314835200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2011,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>To improve the effectiveness of tuberculosis (TB) control programs in the United States by identifying cost-effective priorities for screening for latent tuberculosis infection (LTBI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To estimate the cost-effectiveness of LTBI screening using the tuberculin skin test (TST) and interferon-\u03b3 release assays (IGRAs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A Markov model of screening for LTBI with TST and IGRA in risk-groups considered in current LTBI screening guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>In all risk-groups, TST and IGRA screening resulted in increased mean life expectancy, ranging from 0.03\u20130.24 life-months per person screened. IGRA screening resulted in greater life expectancy gains than TST. Screening always cost more than not screening, but IGRA was cost-saving compared with TST in some groups. Four patterns of cost-effectiveness emerged, related to four risk categories. (1) Individuals at highest risk of TB reactivation (close contacts and those infected with HIV): the incremental cost-effectiveness ratio (ICER) of IGRA compared with TST was less than $100,000 per quality-adjusted life year (QALY) gained. (2) The foreign-born: IGRA was cost-saving compared with TST and cost-effective compared with no screening (ICER &amp;lt;$100,000 per QALY gained). (3) Vulnerable populations (e.g., homeless, drug user, or former prisoner): the ICER of TST screening was approximately $100,000\u2013$150,000 per QALY gained, but IGRA was not cost-effective. (4) Medical comorbidities (e.g., diabetes): the ICER of screening with TST or IGRA was greater than $100,000 per QALY.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>LTBI screening guidelines could make progress toward TB elimination by prioritizing screening for close contacts, those infected with HIV, and the foreign-born regardless of time living in the United States. For these groups, IGRA screening was more cost-effective than TST screening.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1164\/rccm.201101-0181oc","type":"journal-article","created":{"date-parts":[[2011,5,11]],"date-time":"2011-05-11T21:48:08Z","timestamp":1305150488000},"page":"590-601","source":"Crossref","is-referenced-by-count":127,"title":["Priorities for Screening and Treatment of Latent Tuberculosis Infection in the United States"],"prefix":"10.1093","volume":"184","author":[{"given":"Benjamin P.","family":"Linas","sequence":"first","affiliation":[{"name":"Section of Infectious Diseases, Boston Medical Center"},{"name":"Department of Epidemiology, Boston University School of Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela Y.","family":"Wong","sequence":"additional","affiliation":[{"name":"Divisions of Infectious Diseases and"},{"name":"General Medicine, Massachusetts General Hospital; and the"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth A.","family":"Freedberg","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Boston University School of Public Health"},{"name":"Divisions of Infectious Diseases and"},{"name":"General Medicine, Massachusetts General Hospital; and the"},{"name":"Harvard Center for AIDS Research (CFAR), Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr.","given":"C. 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