| Title |
The potential of a multiplex high-throughput molecular assay for early detection of first and second line tuberculosis drug resistance mutations to improve infection control and reduce costs: a decision analytical modeling study
|
|---|---|
| Published in |
BMC Infectious Diseases, October 2015
|
| DOI | 10.1186/s12879-015-1205-4 |
| Pubmed ID | |
| Authors |
AH van’t Hoog, I. Bergval, N. Tukvadze, S. Sengstake, R. Aspindzelashvili, RM Anthony, F. Cobelens |
| Abstract |
Molecular resistance detection (MRD) of resistance to second-line anti-tuberculous drugs provides faster results than phenotypic tests, may shorten treatment and allow earlier separation among patients with and without second-line drug resistance. In a decision-analytical model we simulated a cohort of patients diagnosed with TB in a setting where drug resistant TB is highly prevalent and requires initial hospitalization, to explore the potential benefits of a high-throughput MRD-assay for reducing potential nosocomial transmission of highly resistant strains, and total costs for diagnosis of drug resistance, treatment and hospitalization. In the base case scenario first-line drug resistance was diagnosed with WHO-endorsed molecular tests, and second-line drug resistance with culture and phenotypic methods. Three alternative scenarios were explored, each deploying high-throughput MRD allowing either detection of second-line mutations in cultured isolates, directly on sputum, or MRD with optimized markers. Compared to a base case scenario, deployment of high-throughput MRD reduced total costs by 17-21 %. The period during which nosocomial transmission may take place increased by 15 % compared to the base case if MRD had currently reported suboptimal sensitivity and required cultured isolates; increased by 7 % if direct sputum analysis were possible including in patients with smear-negative TB, and reduced by 24 % if the assay had improved markers, but was still performed on cultured isolates. Improved clinical sensitivity of the assay (additional markers) by more than 35 % would be needed to avoid compromising infection control. Further development of rapid second-line resistance testing should prioritize investment in optimizing markers above investments in a platform for direct analysis of sputum. |
X Demographics
The data shown below were collected from the profile of 1 X user who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 52 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Canada | 1 | 2% |
| Unknown | 51 | 98% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 11 | 21% |
| Student > Master | 8 | 15% |
| Student > Doctoral Student | 6 | 12% |
| Student > Postgraduate | 4 | 8% |
| Student > Bachelor | 3 | 6% |
| Other | 8 | 15% |
| Unknown | 12 | 23% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 19 | 37% |
| Biochemistry, Genetics and Molecular Biology | 3 | 6% |
| Pharmacology, Toxicology and Pharmaceutical Science | 2 | 4% |
| Agricultural and Biological Sciences | 2 | 4% |
| Decision Sciences | 2 | 4% |
| Other | 7 | 13% |
| Unknown | 17 | 33% |
Attention Score in Context
This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 09 August 2021.
All research outputs
#7,235,782
of 22,867,327 outputs
Outputs from BMC Infectious Diseases
#2,386
of 7,687 outputs
Outputs of similar age
#92,040
of 284,441 outputs
Outputs of similar age from BMC Infectious Diseases
#59
of 166 outputs
Altmetric has tracked 22,867,327 research outputs across all sources so far. This one has received more attention than most of these and is in the 67th percentile.
So far Altmetric has tracked 7,687 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 9.6. This one has gotten more attention than average, scoring higher than 67% of its peers.
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We're also able to compare this research output to 166 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 63% of its contemporaries.