{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T09:16:58Z","timestamp":1788945418967,"version":"build-2803163510"},"reference-count":65,"publisher":"European Respiratory Society (ERS)","issue":"1","license":[{"start":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T00:00:00Z","timestamp":1745366400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["Eur Respir J"],"accepted":{"date-parts":[[2025,3,11]]},"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Optimising tuberculosis disease testing algorithms is fundamental to ensuring the effectiveness and cost-effectiveness of migrant screening programmes, including better understanding of individual and combined screening test properties. The aim of our study was to estimate pooled tuberculosis test properties from the literature and combine them in decision analytical modelling with a focus on whether tests used for the diagnosis of tuberculosis infection might add value to these algorithms.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We performed a systematic review of reviews of diagnostic tests for active tuberculosis, searching PubMed, Embase, Web of Science and Cochrane library, and pooled test properties extracted from original papers included in reviews. We used these pooled results in a decision tree analysis to estimate test properties for common migrant screening algorithms.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We retrieved 1477 records and included 32 reviews, including data from 437 original studies for 18 tuberculosis tests, providing pooled results for 13. Our modelling showed that algorithms with interferon-\u03b3 release assays had the highest diagnostic odds ratios (dORs) (<jats:italic>e.g.<\/jats:italic> QuantiFERON\/chest X-ray (for tuberculosis abnormalities)\/Xpert dOR 24\u2009670, 95% CI 11\u2009630\u201352\u2009328) and high positive predictive values. Best sensitivities were achieved for combinations with parallel cough\/chest X\u2011ray screening followed by Xpert (0.88, 95% CI 0.86\u20130.90) or Ultra (0.92, 95% CI 0.90\u20130.94) as well as by T-Spot.TB followed by parallel symptom\/chest X-ray screening and Ultra (0.81, 95% CI 0.78\u20130.83) or Xpert (0.77, 95% CI 0.75\u20130.80).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The significant test accuracy benefit of adding interferon-\u03b3 release assays to an active tuberculosis screening pathway will help inform clinicians and policy-makers on the most effective screening algorithms.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1183\/13993003.02000-2024","type":"journal-article","created":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T21:35:16Z","timestamp":1745444116000},"page":"2402000","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["How to diagnose TB in migrants? 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