{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T07:13:51Z","timestamp":1774077231169,"version":"3.50.1"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2016,8,1]],"date-time":"2016-08-01T00:00:00Z","timestamp":1470009600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K23 AI085036"],"award-info":[{"award-number":["K23 AI085036"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["T32 HL007287"],"award-info":[{"award-number":["T32 HL007287"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["F32 HL125031"],"award-info":[{"award-number":["F32 HL125031"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,8,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Latent tuberculosis infection (LTBI) test discordance is poorly understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine the frequency and predictors of tuberculin skin test (TST) and QuantiFERON-TB Gold In-Tube test (QFT) discordance in the U.S. population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed data from a representative sample of the U.S. population ages 6 years and older who participated in the 2011\u20132012 National Health and Nutrition Examination Survey. We determined prevalence estimates of test positivity, calculated test agreement and kappa statistics, and performed multivariable logistic regression to determine predictors of discordance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>LTBI prevalence among the U.S. born ranged from 0.6% to 2.8%, depending on how LTBI was defined, with test agreement 97.0% and kappa 0.27 (95% confidence interval, 0.18\u20130.36). Prevalence among the foreign born ranged from 9.1% to 20.3%, depending on how LTBI was defined, with test agreement 81.6% and kappa 0.38 (95% confidence interval, 0.33\u20130.44). TST+\/QFT\u2212 discordance was associated with age, male sex, black race, Mexican-American ethnicity, previous TB exposure, and past LTBI treatment in U.S.-born participants, but only with higher lymphocyte count in foreign-born participants. TST\u2212\/QFT+ discordance was associated with older age, previous TB exposure, and past LTBI treatment in U.S.-born participants and with older age, male sex, and past LTBI treatment in foreign-born participants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In the largest population-based sample of concurrently performed TST and QFT tests in a low tuberculosis incidence population, prevalence estimates depended heavily on how LTBI was defined and test agreement was only fair. We identified several predictors of discordance warranting further study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1164\/rccm.201508-1560oc","type":"journal-article","created":{"date-parts":[[2016,2,18]],"date-time":"2016-02-18T19:19:11Z","timestamp":1455823151000},"page":"493-500","source":"Crossref","is-referenced-by-count":19,"title":["Latent Tuberculosis Infection Test Agreement in the National Health and Nutrition Examination Survey"],"prefix":"10.1093","volume":"194","author":[{"given":"Bijan J.","family":"Ghassemieh","sequence":"first","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Department of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Engi F.","family":"Attia","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Department of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David M.","family":"Koelle","sequence":"additional","affiliation":[{"name":"Division of Allergy and Infectious Diseases, Department of Medicine"},{"name":"Department of Laboratory Medicine"},{"name":"Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington"},{"name":"Department of Global Health, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James D.","family":"Mancuso","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiro","family":"Narita","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Department of Medicine"},{"name":"Firland Northwest Tuberculosis Center, University of Washington, Seattle, Washington"},{"name":"TB Control Program, Public Health \u2013 Seattle & King County, Seattle, Washington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David J.","family":"Horne","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Department of Medicine"},{"name":"Department of Global Health, and"},{"name":"Firland Northwest Tuberculosis Center, University of Washington, Seattle, Washington"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2016,8,15]]},"reference":[{"key":"2026032023531184800_bib1","article-title":"Global tuberculosis report 2014","author":"World Health Organization (WHO)","year":"2014"},{"key":"2026032023531184800_bib2","doi-asserted-by":"crossref","first-page":"S221","DOI":"10.1164\/ajrccm.161.supplement_3.ats600","article-title":"Targeted tuberculin testing and treatment of latent tuberculosis infection","volume":"161","author":"American Thoracic Society (ATS)","year":"2000","journal-title":"Am J Respir Crit Care Med"},{"key":"2026032023531184800_bib3","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1128\/CMR.00034-13","article-title":"Gamma interferon release assays for detection of Mycobacterium tuberculosis infection","volume":"27","author":"Pai","year":"2014","journal-title":"Clin Microbiol Rev"},{"key":"2026032023531184800_bib4","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1164\/rccm.201302-0365OC","article-title":"Interferon-\u03b3 release assays and tuberculin skin testing for diagnosis of latent tuberculosis infection in healthcare workers in the United States","volume":"189","author":"Dorman","year":"2014","journal-title":"Am J Respir Crit Care Med"},{"key":"2026032023531184800_bib5","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1164\/rccm.201203-0430OC","article-title":"Test variability of the QuantiFERON-TB Gold In-Tube assay in clinical practice","volume":"187","author":"Metcalfe","year":"2013","journal-title":"Am J Respir Crit Care Med"},{"key":"2026032023531184800_bib6","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1111\/j.1469-0691.2011.03555.x","article-title":"Guidelines on interferon-\u03b3 release assays for tuberculosis infection: concordance, discordance or confusion?","volume":"17","author":"Denkinger","year":"2011","journal-title":"Clin Microbiol Infect"},{"key":"2026032023531184800_bib7","first-page":"1352","article-title":"Preventive chemotherapy. 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