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. Author manuscript; available in PMC: 2018 Sep 25.
Published in final edited form as: N Engl J Med. 2018 Sep 26;379(15):1403–1415. doi: 10.1056/NEJMoa1800474
Phenotypic profiles R S U F Total R S U F Total Prevalence of resistance among each of the listed drug profiles, % Sensitivity, % Specificity, % PPV, % NPV,% Expected NPV at given prevalence of resistance based on simulations, % (95% CI)* Calculated NPV at 20% prevalence of resistance, % (see table S3) Calculated NPV at 40% prevalence of resistance, % (see table S3)
Isoniazid -SSS 391 30 18 12 451 21 4,653 133 104 4,911 8.4 93 100 95 99.4 99.3-100 98.2 95.4
-RSS 459 21 20 6 506 7 85 5 1 98 83.8 96 92 98 80.2 83.5-100 98.8 96.9
-RRS 424 3 13 4 444 2 2 2 0 6 98.7 99 50 100 40.0 73.7-85.6 99.6 99.1
-SRS 24 4 1 0 29 0 10 1 0 11 72.5 86 100 100 71.4 90.5-95.6 96.6 91.3
-SSR 24 1 2 1 28 0 95 6 3 104 21.2 96 100 100 99.0 98.5-99.7 99 97.4
-RRR 662 3 11 4 680 0 0 0 0 0 100.0 100 . 100 0.0 73.7-85.6 n/a n/a
-RSR 217 3 5 5 230 0 3 0 0 3 98.7 99 100 100 50.0 73.7-85.6 99.7 99.1
-SRR 13 0 0 2 15 0 0 0 0 0 100.0 100 . 100 . 73.7-85.6 n/a n/a
Rifampicin S-SS 74 16 0 8 98 30 4,632 126 123 4,911 2.0 82 99 71 99.7 99.3-100 95.7 89.3
S-RS 6 0 0 0 6 1 9 1 0 11 35.3 100 90 86 100.0 97.8-99.5 100 100
S-SR 1 2 0 0 3 0 100 3 1 104 2.8 33 100 100 98.0 99.3-100 85.7 69.2
S-RR 0 0 0 0 0 0 0 0 0 0 . . . . . . n/a n/a
R-SS 464 20 1 21 506 18 424 3 6 451 52.9 96 96 96 95.5 95.8-98.6 98.9 97.2
R-RS 424 7 2 11 444 4 25 0 0 29 93.9 98 86 99 78.1 76.2-86.6 99.5 98.8
R-SR 218 4 0 8 230 7 20 0 1 28 89.1 98 74 97 83.3 77.9-87.9 99.4 98.4
R-RR 665 2 0 13 680 10 3 0 2 15 97.8 100 23 99 60.0 76.2-86.6 99.7 99.1
Ethambutol SS-S 1 9 1 0 11 4 4,399 472 36 4,911 0.2 10 100 20 99.8 98.8-99.9 81.6 62.5
RS-S 21 5 3 0 29 31 376 40 4 451 6.0 81 92 40 98.7 98.8-99.9 95.1 87.8
SR-S 4 2 0 0 6 1 93 3 1 98 5.8 67 99 80 97.9 98.8-99.9 92.2 81.7
RR-S 375 20 30 19 444 203 241 48 14 506 46.7 95 54 65 92.3 93.4-96.7 97.7 94.1
SS-R 0 0 0 0 0 1 81 22 0 104 0.0 . 99 0 100.0 98.8-99.9 n/a n/a
RS-R 12 2 1 0 15 7 20 1 0 28 34.9 86 74 63 90.9 95.7-98.1 95.4 88.6
SR-R 0 0 0 0 0 0 3 0 0 3 0.0 . 100 . 100.0 98.8-99.9 n/a n/a
RR-R 625 9 26 20 680 150 50 25 5 230 74.7 99 25 81 84.7 82.0-88.2 98.6 96.4
Pyrazinamide SSS- 74 28 0 2 104 12 4,826 13 60 4,911 2.1 73 100 86 99.4 98.6-99.6 93.6 84.5
RSS- 13 8 4 3 28 5 431 2 13 451 5.8 62 99 72 98.2 98.6-99.6 91.2 79.6
RRS- 166 25 22 17 230 49 374 68 15 506 31.3 87 88 77 93.7 95.5-97.7 96.4 91
SRS- 0 3 0 0 3 0 97 0 1 98 3.0 0 100 . 97.0 98.6-99.6 80 60
RRR- 532 15 83 50 680 107 216 105 16 444 60.5 97 67 83 93.5 87.3-91.0 99 97.3
SRR- 0 0 0 0 0 0 6 0 0 6 0.0 . 100 . 100.0 98.6-99.6 n/a n/a
RSR- 10 2 1 2 15 0 28 0 1 29 34.1 83 100 100 93.3 95.0-97.3 96 90
SSR- 0 0 0 0 0 0 11 0 0 11 0.0 . 100 . 100.0 98.6-99.6 n/a n/a

Phenotypic profiles are listed in the following order: Isoniazid, Rifampicin, Ethambutol, Pyrazinamide. '-' under 'Phenotypic profiles' marks the drug phenotype being assessed. PPV = Positive Predictive Value; NPV = Negative Predictive Value; R=resistant; S=susceptible; U=mutation of unknown association present; F=genotypic prediction failed due to missing data around a genomic resistance locus; All % results based on R/S genotypic predictions only, excluding U and F. Expected NPV was calculated as follows: specificity x (1-prevlence) / (specificity x (1-prevlence)+(1-sensitivity) x prevalence). * indicates that for prevalence <10% or >90%, simulated values are given for 10% and 90% respectively as simulations were not performed below or above these values.