{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T05:10:02Z","timestamp":1745730602896,"version":"3.40.4"},"reference-count":0,"publisher":"International Union Against Tuberculosis and Lung Disease","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["int j tuberc lung dis"],"published-print":{"date-parts":[[2025,4,25]]},"abstract":"<sec><title>BACKGROUND<\/title>Improving the diagnostic confirmation of active TB disease is a key objective of the England & Wales TB Action Plan. However, national data suggest little change in the proportion of TB cases confirmed by positive culture in recent\n years, with 61% of all cases and 74% of pulmonary TB cases confirmed by culture. We report the introduction of a simple tool that records the diagnostic certainty of tuberculosis during cohort review of new TB cases diagnosed within our TB network in an attempt to improve culture confirmation\n rates.<\/sec><sec><title>METHODS<\/title>In North-Central London TB service, we developed a diagnostic certainty score, using results of mycobacterial cultures, molecular diagnostics, microscopy, histology, clinical and radiology results, to grade cases on a 1\u20135\n scale. Since 2017, this has been routinely used as part of our quarterly patient Cohort Reviews. We evaluated the relationship between its introduction and TB culture confirmation.<\/sec><sec><title>RESULTS<\/title>There was a significant improvement in culture\n confirmation rates from 59% in 2017 to 75% in 2022. By 2022, 86% of pulmonary TB cases were confirmed by TB culture and 55% of extrapulmonary cases.<\/sec><sec><title>DISCUSSION<\/title>A simple diagnostic certainty score was associated with improved diagnostic\n confirmation of TB disease and may be helpful for other TB services and TB programmes.<\/sec><\/jats:p>","DOI":"10.5588\/ijtld.24.0418","type":"journal-article","created":{"date-parts":[[2025,4,26]],"date-time":"2025-04-26T04:31:05Z","timestamp":1745641865000},"page":"227-230","source":"Crossref","is-referenced-by-count":0,"title":["A diagnostic certainty score to support improvements in culture confirmation of TB"],"prefix":"10.5588","volume":"29","author":[{"given":"G.","family":"McNally","sequence":"first","affiliation":[{"name":"North Middlesex University Hospital NHS Trust, London, UK;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Solomon","sequence":"additional","affiliation":[{"name":"University College London, London, UK;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Brown","sequence":"additional","affiliation":[{"name":"University College London Hospitals NHS Foundation Trust, London, UK;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Capocci","sequence":"additional","affiliation":[{"name":"University College London Hospitals NHS Foundation Trust, London, UK;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Creer","sequence":"additional","affiliation":[{"name":"Royal Free London NHS Foundation Trust, London, UK;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Dekoningh","sequence":"additional","affiliation":[{"name":"North Central London TB Service, London, UK."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Lozewicz","sequence":"additional","affiliation":[{"name":"North Middlesex University Hospital NHS Trust, London, UK;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Moores","sequence":"additional","affiliation":[{"name":"Royal Free London NHS Foundation Trust, London, UK;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Morris-Jones","sequence":"additional","affiliation":[{"name":"University College London Hospitals NHS Foundation Trust, London, UK;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Potter","sequence":"additional","affiliation":[{"name":"North Middlesex University Hospital NHS Trust, London, UK;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"White","sequence":"additional","affiliation":[{"name":"North Central London TB Service, London, UK."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Lipman","sequence":"additional","affiliation":[{"name":"University College London, London, UK;, Royal Free London NHS Foundation Trust, London, UK;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Brown","sequence":"additional","affiliation":[{"name":"University College London, London, UK;, Royal Free London NHS Foundation Trust, London, UK;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3554","container-title":["The International Journal of Tuberculosis and Lung Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ingentaconnect.com\/content\/iuatld\/ijtld\/2025\/00000029\/00000005\/art00006","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T04:30:31Z","timestamp":1745728231000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ingentaconnect.com\/content\/10.5588\/ijtld.24.0418"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,25]]},"references-count":0,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,4,25]]}},"alternative-id":["1027-3719(20250425)29:5L.227;1-"],"URL":"https:\/\/doi.org\/10.5588\/ijtld.24.0418","relation":{},"ISSN":["1027-3719"],"issn-type":[{"type":"print","value":"1027-3719"}],"subject":[],"published":{"date-parts":[[2025,4,25]]}}}