{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T20:42:28Z","timestamp":1788381748093,"version":"build-2803163510"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2020,4,1]],"date-time":"2020-04-01T00:00:00Z","timestamp":1585699200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":["www.atsjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,4,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Development of diagnostic tools with improved predictive value for tuberculosis (TB) is a global research priority.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We evaluated whether implementing higher diagnostic thresholds than currently recommended for QuantiFERON Gold-in-Tube (QFT-GIT), T-SPOT.TB, and the tuberculin skin test (TST) might improve prediction of incident TB.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Follow-up of a UK cohort of 9,610 adult TB contacts and recent migrants was extended by relinkage to national TB surveillance records (median follow-up 4.7 yr). Incidence rates and rate ratios, sensitivities, specificities, and predictive values for incident TB were calculated according to ordinal strata for quantitative results of QFT-GIT, T-SPOT.TB, and TST (with adjustment for prior bacillus Calmette-Gu\u00e9rin [BCG] vaccination).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>For all tests, incidence rates and rate ratios increased with the magnitude of the test result (P\u2009&amp;lt;\u20090.0001). Over 3 years\u2019 follow-up, there was a modest increase in positive predictive value with the higher thresholds (3.0% for QFT-GIT \u22650.35 IU\/ml vs. 3.6% for \u22654.00 IU\/ml; 3.4% for T-SPOT.TB \u22655 spots vs. 5.0% for \u226550 spots; and 3.1% for BCG-adjusted TST \u22655 mm vs. 4.3% for \u226515 mm). As thresholds increased, sensitivity to detect incident TB waned for all tests (61.0% for QFT-GIT \u22650.35 IU\/ml vs. 23.2% for \u22654.00 IU\/ml; 65.4% for T-SPOT.TB \u22655 spots vs. 27.2% for \u226550 spots; 69.7% for BCG-adjusted TST \u22655 mm vs. 28.1% for \u226515 mm).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Implementation of higher thresholds for QFT-GIT, T-SPOT.TB, and TST modestly increases positive predictive value for incident TB, but markedly reduces sensitivity. Novel biomarkers or validated multivariable risk algorithms are required to improve prediction of incident TB.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1164\/rccm.201905-0969oc","type":"journal-article","created":{"date-parts":[[2019,12,11]],"date-time":"2019-12-11T13:56:17Z","timestamp":1576072577000},"page":"984-991","update-policy":"https:\/\/doi.org\/10.1164\/crossmarkpolicies","source":"Crossref","is-referenced-by-count":47,"title":["Quantitative IFN-\u03b3 Release Assay and Tuberculin Skin Test Results to Predict Incident Tuberculosis. A Prospective Cohort Study"],"prefix":"10.1093","volume":"201","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6257-1285","authenticated-orcid":false,"given":"Rishi K.","family":"Gupta","sequence":"first","affiliation":[{"name":"Institute for Global Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7501-4448","authenticated-orcid":false,"given":"Marc","family":"Lipman","sequence":"additional","affiliation":[{"name":"UCL-TB"},{"name":"UCL Respiratory, and"},{"name":"Royal Free London National Health Service (NHS) Foundation Trust, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8544-7685","authenticated-orcid":false,"given":"Charlotte","family":"Jackson","sequence":"additional","affiliation":[{"name":"Institute for Global Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice J.","family":"Sitch","sequence":"additional","affiliation":[{"name":"National Institute for Health Research Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, United Kingdom"},{"name":"Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo","family":"Southern","sequence":"additional","affiliation":[{"name":"Tuberculosis Unit, Public Health England, Colindale, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis","family":"Drobniewski","sequence":"additional","affiliation":[{"name":"Section of Infectious Diseases and Immunity and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan J.","family":"Deeks","sequence":"additional","affiliation":[{"name":"National Institute for Health Research Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, United Kingdom"},{"name":"Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuen-Yan","family":"Tsou","sequence":"additional","affiliation":[{"name":"Tuberculosis Unit, Public Health England, Colindale, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Griffiths","sequence":"additional","affiliation":[{"name":"Barts Institute of Population Health Sciences and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1599-7504","authenticated-orcid":false,"given":"Jennifer","family":"Davidson","sequence":"additional","affiliation":[{"name":"Tuberculosis Unit, Public Health England, Colindale, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6239-3378","authenticated-orcid":false,"given":"Colin","family":"Campbell","sequence":"additional","affiliation":[{"name":"Tuberculosis Unit, Public Health England, Colindale, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8705-3281","authenticated-orcid":false,"given":"Oliver","family":"Stirrup","sequence":"additional","affiliation":[{"name":"Institute for Global Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4774-0853","authenticated-orcid":false,"given":"Mahdad","family":"Noursadeghi","sequence":"additional","affiliation":[{"name":"Division of Infection and Immunity, University College London, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0380-1116","authenticated-orcid":false,"given":"Heinke","family":"Kunst","sequence":"additional","affiliation":[{"name":"Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom"},{"name":"Department of Respiratory Medicine, Barts Health NHS Trust, London, United Kingdom; 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