Drain 2015a.

Study characteristics
Patient sampling	Cross‐sectional, prospective and consecutive enrolment
Patient characteristics and setting	Presenting signs and symptoms: HIV‐infected adults included irrespective of symptoms. Proportion of participants that reported with tuberculosis signs and symptoms symptomatic not stated. Age: mean 33 (SD 9) Sex, female: 49% HIV infection: 100% Median CD4 cell count per µL: 248 (IQR 107 to 379) History of tuberculosis: 9% Sample size: 320 Clinical setting: outpatient Country: South Africa Tuberculosis incidence rate: 567 per 100,000 Number (proportion) of tuberculosis cases in the study: 54 (17%)
Index tests	LF‐LAM
Target condition and reference standard(s)	Target condition: pulmonary tuberculosis Reference standard: mycobacterial culture of sputum (solid); no extrapulmonary specimens tested
Flow and timing	All patients were included in the analysis
Comparative
Notes	The study authors performed sputum induction for individuals who could not expectorate, excluded individuals without some respiratory specimen available. They did not attempt to identify extrapulmonary tuberculosis.
Methodological quality
Item	Authors' judgement	Risk of bias	Applicability concerns
DOMAIN 1: Patient Selection
Was a consecutive or random sample of patients enrolled?	Yes
Was a case‐control design avoided?	Yes
Did the study avoid inappropriate exclusions?	No
		High	Low
DOMAIN 2: Index Test All tests
Were the index test results interpreted without knowledge of the results of the reference standard?	Yes
If a threshold was used, was it pre‐specified?	Yes
		Low	Low
DOMAIN 3: Reference Standard
Is the reference standards likely to correctly classify the target condition?	No
Were the reference standard results interpreted without knowledge of the results of the index tests?	Yes
		High	Low
DOMAIN 4: Flow and Timing
Was there an appropriate interval between index test and reference standard?	Yes
Did all patients receive the same reference standard?	Yes
Were all patients included in the analysis?	Yes
		Low