{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:26:20Z","timestamp":1787315180493,"version":"build-2736575974"},"reference-count":40,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Medicine and Pharmacy of Craiova, Romania"},{"id":[{"id":"https:\/\/ror.org\/031d5vw30","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Background: Early identification of patients who will remain sputum-culture-positive at two months could support risk-adapted tuberculosis (TB) monitoring. We developed a compact baseline score from routine admission data measured before anti-TB therapy. Methods: The cohort comprised 155 adults (62 culture-positive and 93 culture-negative at two months). Random Forest ranking and correlation clustering were used as exploratory selection steps. The complete development pipeline was evaluated by repeated fully nested cross-validation; a secondary conditional analysis held the full-cohort-selected candidate set fixed. Results: The fully nested pipeline yielded a mean test-fold AUC of 0.70 \u00b1 0.09 (fold-level percentile interval 0.53\u20130.85). Conditional on full-cohort predictor preselection, mean test-fold AUC was 0.74 \u00b1 0.08, and the patient-level mean repeated out-of-fold score AUC was 0.75 (bootstrap 95% CI 0.67\u20130.83). At provisional thresholds of \u22652, \u22653 and \u22654 points, conditional procedure sensitivity\/specificity were 0.90\/0.39, 0.80\/0.60 and 0.57\/0.74, respectively. The conditional repeated out-of-fold Brier score was 0.200, with calibration intercept approximately 0.00 and slope 0.74. Conclusions: TB-CAST is an exploratory score with moderate internal discrimination. The fully nested result is the primary internal estimate for the complete data-driven pipeline; the conditional results and provisional thresholds require prospective external validation before clinical use.<\/jats:p>","DOI":"10.3390\/life16081384","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T11:37:34Z","timestamp":1787312254000},"page":"1384","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["New Strategies in Tuberculosis Prediction: TB-CAST, an Explainable Baseline Score for Two-Month Sputum Culture Positivity"],"prefix":"10.3390","volume":"16","author":[{"given":"Marinela-Alina","family":"Miulescu","sequence":"first","affiliation":[{"name":"Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"},{"name":"Leamna Pneumology Hospital, 207129 Leamna, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor-Ionel","family":"Grecu","sequence":"additional","affiliation":[{"name":"\u201cVictor Babe\u0219\u201d Infectious Diseases and Pneumophthisiology Hospital, 200515 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liliana","family":"Streba","sequence":"additional","affiliation":[{"name":"Department of Oncology and Palliative Care, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"C\u0103l\u0103ra\u0219u","sequence":"additional","affiliation":[{"name":"Leamna Pneumology Hospital, 207129 Leamna, Romania"},{"name":"Department of Pulmonology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3687-2468","authenticated-orcid":false,"given":"Patricia-Mihaela","family":"R\u0103dulescu","sequence":"additional","affiliation":[{"name":"Department of Pulmonology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Costin-Teodor","family":"Streba","sequence":"additional","affiliation":[{"name":"Leamna Pneumology Hospital, 207129 Leamna, Romania"},{"name":"Department of Pulmonology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"TNMI7-0036-2016","DOI":"10.1128\/microbiolspec.TNMI7-0036-2016","article-title":"Tuberculosis\u2014A World Health Organization perspective","volume":"5","author":"Sotgiu","year":"2017","journal-title":"Microbiol. 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