{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T23:10:42Z","timestamp":1756681842352,"version":"3.41.0"},"reference-count":30,"publisher":"European Respiratory Society (ERS)","issue":"2","funder":[{"DOI":"10.13039\/501100000190","name":"University of Alberta","doi-asserted-by":"publisher","award":["UOFAB UHF Long"],"award-info":[{"award-number":["UOFAB UHF Long"]}],"id":[{"id":"10.13039\/501100000190","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["ERJ Open Res"],"accepted":{"date-parts":[[2018,2,28]]},"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:p>Our objective was to investigate whether pulmonary tuberculosis (PTB) can be predicted from features of a targeted medical history and basic laboratory investigations in immigrants.<\/jats:p><jats:p>A retrospective cohort of 391 foreign-born adults referred to the Edmonton Tuberculosis Clinic (Edmonton, AB, Canada) was studied using multiple logistic regression analysis to predict PTB. Seven characteristics of disease were used as explanatory variables. Cross-validation assessed performance. Each predictor was tested on two outcomes: \u201cculture-positive\u201d and \u201csmear-positive\u201d. Receiver operating characteristic (ROC) curves were generated and the area under the ROC curve (AUC) was quantified.<\/jats:p><jats:p>Symptoms, subacute duration of symptoms, risk factors for reactivation of latent TB infection and anaemia were all associated with a positive culture (adjusted OR 1.79, 2.24, 1.72 and 2.28, respectively; p&lt;0.05). Symptoms, inappropriate prescription of broad-spectrum antibiotics and a \u201ctypical\u201d chest radiograph were associated with smear-positive PTB (adjusted OR 2.91, 1.55 and 12.34, respectively; p&lt;0.05). ROC curve analysis was used to test each model, yielding AUC=0.91 for the outcome \u201cculture-positive\u201d disease and AUC=0.94 for the outcome \u201csmear-positive\u201d disease.<\/jats:p><jats:p>PTB among the foreign-born can be predicted from a targeted medical history and basic laboratory investigations, raising the threshold of suspicion in settings where the disease is relatively rare.<\/jats:p>","DOI":"10.1183\/23120541.00170-2017","type":"journal-article","created":{"date-parts":[[2018,4,20]],"date-time":"2018-04-20T09:55:10Z","timestamp":1524218110000},"page":"00170-2017","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Predicting pulmonary tuberculosis in immigrants: a retrospective cohort study"],"prefix":"10.1183","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1241-7201","authenticated-orcid":false,"given":"Courtney","family":"Heffernan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Doroshenko","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary Lou","family":"Egedahl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Barrie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ambikaipakan","family":"Senthilselvan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Long","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"81","published-online":{"date-parts":[[2018,4,20]]},"reference":[{"key":"2024101707091940000_4.2.00170-2017.1","unstructured":"World Health Organization. Global Tuberculosis Report. 2016. www.who.int\/tb\/publications\/global_report\/en\/ Date last accessed: October 12, 2017."},{"key":"2024101707091940000_4.2.00170-2017.2","unstructured":"Government of Canada. Tuberculosis in Canada 2014: Pre-release. 2014. www.canada.ca\/en\/public-health\/services\/publications\/diseases-conditions\/tuberculosis-canada-2014-pre-release.html Date last accessed: October 12, 2017."},{"key":"2024101707091940000_4.2.00170-2017.3","unstructured":"Statistics Canada. Population by year, province and territory. www.statcan.gc.ca\/tables-tableaux\/sum-som\/l01\/cst01\/demo02a-eng.htm Date last accessed: October 15, 2017. Date last updated: September 27, 2017."},{"key":"2024101707091940000_4.2.00170-2017.4","unstructured":"World Health Organization. Global Tuberculosis Control: Surveillance, Planning Financing . Geneva, Switzerland, 2008."},{"key":"2024101707091940000_4.2.00170-2017.5","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.150317"},{"key":"2024101707091940000_4.2.00170-2017.6","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00196610"},{"key":"2024101707091940000_4.2.00170-2017.7","doi-asserted-by":"crossref","first-page":"e0144784","DOI":"10.1371\/journal.pone.0144784","article-title":"Do \u201cvirtual\u201d and \u201coutpatient\u201d public health tuberculosis clinics perform equally well? a program-wide evaluation in Alberta, Canada","volume":"10:","author":"Long","year":"2015","journal-title":"PLoS One"},{"key":"2024101707091940000_4.2.00170-2017.8","doi-asserted-by":"crossref","first-page":"E397","DOI":"10.33321\/cdi.2014.38.64","article-title":"Essential components of a tuberculosis control program within Australia","volume":"38","author":"The National Tuberculosis Advisory Committee","year":"2014","journal-title":"Commun Dis Intell Q Rep"},{"key":"2024101707091940000_4.2.00170-2017.9","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1155\/2015\/826035","article-title":"Making a timely diagnosis of pulmonary tuberculosis","volume":"22","author":"Long","year":"2015","journal-title":"Can Respir J"},{"key":"2024101707091940000_4.2.00170-2017.10","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(19980730)17:14<1623::AID-SIM871>3.0.CO;2-S"},{"key":"2024101707091940000_4.2.00170-2017.11","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-065X.2010.00984.x"},{"key":"2024101707091940000_4.2.00170-2017.12","doi-asserted-by":"crossref","first-page":"e0154032","DOI":"10.1371\/journal.pone.0154032","article-title":"Chest radiograph patterns and the transmission of tuberculosis: implications for automated systems","volume":"11","author":"Lau","year":"2016","journal-title":"PLoS One"},{"key":"2024101707091940000_4.2.00170-2017.13","doi-asserted-by":"crossref","unstructured":"Vach W . Regression Models as a Tool in Medical Research. Boca Raton, CRC Press, 2013.","DOI":"10.1201\/b12925"},{"key":"2024101707091940000_4.2.00170-2017.14","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwu140"},{"key":"2024101707091940000_4.2.00170-2017.15","first-page":"1213","article-title":"Transmission characteristics of tuberculosis in the foreign-born and the Canadian-born populations of Alberta, Canada","volume":"8","author":"Kunimoto","year":"2004","journal-title":"Int J Tuberc Lung Dis"},{"key":"2024101707091940000_4.2.00170-2017.16","doi-asserted-by":"publisher","DOI":"10.1378\/chest.113.4.933"},{"key":"2024101707091940000_4.2.00170-2017.17","unstructured":"Bass JB Jr . Dyspnea. In: Walker HK , Hall WD , Hurst JW , eds. Clinical Methods: The History, Physical, and Laboratory Examinations . 3rd Edn. Boston, Butterworths, 1990; pp. 78\u201380."},{"key":"2024101707091940000_4.2.00170-2017.18","unstructured":"Public Health Agency of Canada, Canadian Lung Association, Canadian Thoracic Society. Canadian Tuberculosis Standards . 7th Edn. Ottawa, Canada, 2013."},{"key":"2024101707091940000_4.2.00170-2017.19","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1164\/rccm.201308-1480OC","article-title":"Persistent latent tuberculosis reactivation risk in United States immigrants","volume":"189","author":"Walter","year":"2014","journal-title":"Am J Respir Crit Care Med"},{"key":"2024101707091940000_4.2.00170-2017.20","doi-asserted-by":"publisher","DOI":"10.1016\/0041-3879(91)90054-V"},{"key":"2024101707091940000_4.2.00170-2017.21","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1186\/s12879-017-2309-9","article-title":"Development and validation of a prognostic score during tuberculosis treatment","volume":"17","author":"Pefura-Yone","year":"2017","journal-title":"BMC Infect Dis"},{"key":"2024101707091940000_4.2.00170-2017.22","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1017\/S0950268802007604","article-title":"Predicting tuberculosis among migrant groups","volume":"129","author":"Watkins","year":"2002","journal-title":"Epidemiol Infect"},{"key":"2024101707091940000_4.2.00170-2017.23","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-14-532"},{"key":"2024101707091940000_4.2.00170-2017.24","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000391"},{"key":"2024101707091940000_4.2.00170-2017.25","doi-asserted-by":"crossref","first-page":"405","DOI":"10.5588\/ijtld.13.0625","article-title":"Preventing tuberculosis in the foreign-born population of Canada: a mathematical modeling study","volume":"18","author":"Varughese","year":"2014","journal-title":"Int J Tuberc Lung Dis"},{"key":"2024101707091940000_4.2.00170-2017.26","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1080\/01621459.1983.10477973","article-title":"Estimating the error rate of a prediction rule: improvement on cross-validation","volume":"78","author":"Efron","year":"1982","journal-title":"J Am Stat Assoc"},{"key":"2024101707091940000_4.2.00170-2017.27","unstructured":"Stop TB Partnership. Stop TB Partnership and its Partners \u2018Unite to End TB\u2019 by Launching a Social Impact Fund and an Accelerator for Impact. 2016. www.stoptb.org\/news\/stories\/2016\/ns16_052.asp Date last accessed: October 15, 2017."},{"key":"2024101707091940000_4.2.00170-2017.28","doi-asserted-by":"publisher","DOI":"10.5588\/ijtld.11.0374"},{"key":"2024101707091940000_4.2.00170-2017.29","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.161.3.9902005"},{"key":"2024101707091940000_4.2.00170-2017.30","doi-asserted-by":"publisher","DOI":"10.5588\/ijtld.12.0129"}],"container-title":["ERJ Open Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1183\/23120541.00170-2017","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T20:09:27Z","timestamp":1751573367000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.ersnet.org\/lookup\/doi\/10.1183\/23120541.00170-2017"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,4]]},"references-count":30,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2018,4,20]]},"published-print":{"date-parts":[[2018,4]]}},"alternative-id":["10.1183\/23120541.00170-2017"],"URL":"https:\/\/doi.org\/10.1183\/23120541.00170-2017","relation":{},"ISSN":["2312-0541"],"issn-type":[{"type":"electronic","value":"2312-0541"}],"subject":[],"published":{"date-parts":[[2018,4]]}}}