Table 1.
Variable | Base-Case Value* | Base-Case References | Distribution Type | Other references |
---|---|---|---|---|
| ||||
Probabilities and Rates
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Sensitivity TST | 0.90 (0.88–1.00) | 5, 58 | logit | 6, 31, 46, 47, 51, |
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Specificity TST | 0.68 (0.52–0.84) | 5, 46 | logit | 55, 58–62 |
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Sensitivity questionnaire | 0.46 | 34 | - | 63 |
| ||||
Specificity questionnaire | 0.94 | |||
| ||||
Sensitivity IGRA | 0.90 (0.77–0.99) | 3, 5, 31, 47, 53, 58 | logit | 46, 55, 59, 64 |
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Specificity IGRA | 0.97 (0.90–1.00) | |||
| ||||
IGRA indeterminate | 0.03 (0.02–0.05) | 31 | logit | 3, 21, 53 |
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Prevalence of LTBI | 0.011 (0.005–0.024) | 42 | logit | 52, 65–67 |
| ||||
RR of LTBI reactivation while on steroids | 7.7 (2.8–21.4) | 25 | log normal | 8–10, 68 |
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Probability of death from TB on steroids | 0.01 | estimated | - | 11, 31, 68 |
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INH effectiveness | 75% | 13 | - | 6, 7, 13, 31, 47, 50, 52, 69–71 |
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INH hepatitis | 0.004 (0.001–0.010) | 6 | beta | 31 |
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Death from INH hepatitis | 0.00002 | 6, 27 | ||
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Probability of death from active NS | 0.007 | 72 | - | 16, 17, 73 |
| ||||
Probability of active TB on initial presentation | 0.00001 | 74 | ||
| ||||
Discount rate (per y) | 3% | |||
| ||||
Utilities
| ||||
Well | 1.0 | - | ||
| ||||
Latent TB | 0.997 | 31, 75, 76 | - | 30 |
| ||||
Active TB | 0.68 (0.65–0.72) | 26, 30 | logit | 31 |
| ||||
NS | 0.90 | 77 | - | |
| ||||
INH hepatitis x 1 mo | 0.85 | 31 | - | 52 |
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Death | 0.0 | - | ||
| ||||
Costs (2010 United States $)
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TST | 39.64 | 36 | - | 31, 47, 51, 66, 78–80 |
Test | 6.88 | |||
Nurse Interpretation | 3.50 | |||
Travel time/lost work | 29.26 | |||
| ||||
Questionnaire | 1.62 | 51 | - | |
| ||||
IGRA | 84.56 | 36 | 45 | |
| ||||
LTBI | 772.29 | 6, 36, 37 | - | 13, 31, 47, 51, 52, 66, 78, 80 |
Level 4 visit | 98.70 | |||
Chest x-ray (2 views) | 30.45 | |||
Level 3 visit x 8 | 312.64 | |||
9 mo of INH | 67.16 | |||
Parent lost time x 9 | 263.34 | |||
| ||||
Active TB | 60,000.00 | 31 | - | 18, 31, 35, 47, 50–52, 66, 78, 80, 81 |
| ||||
INH hepatitis x 1 mo | 539.74 | 31, 36, 37 | - | |
Level 4 visit x 2 | 197.40 | |||
Liver function tests x 2 | 17.78 | |||
Parent lost time x 2 | 58.52 | |||
6 mo of rifampin | 266.04 | |||
| ||||
Death (TB, hepatic failure, or NS) | 100,000.00 | estimated31 | - | |
NS onset | 420.48 | 36, 78, 82 | - | |
Level 3 visit x 3 | 117.24 | |||
Steroids x 6 mo | 215.46 | |||
Parent lost time x 3 | 87.78 | |||
| ||||
NS relapse | 140.16 | 36, 78, 82 | - | |
Level 3 visit x 1 | 39.08 | |||
Steroids x 1 mo | 71.82 | |||
Parent lost time x 1 | 29.26 |
Values in parentheses are 95% confidence interval or clinically plausible range.
Abbreviations: TB, tuberculosis; LTBI, latent tuberculosis infection; IGRA, interferon-γ release assay; NS, nephrotic syndrome; INH, isoniazid; TST, tuberculin skin testing; RR, relative risk;