Table 1.
Baseline estimates for selected variables
| Baseline value | One-way sensitivity analysis range | Distribution in probability sensitivity analysis | References | |
|---|---|---|---|---|
| Prevalence of LTBI in nursing-home residents | 0·30 | 0·13–0·61 | Beta | [17, 18, 32] |
| Prevalence of active TB in nursing-home residents | 0·00 114 | 0·001–0·003 | Beta | [1, 17] |
| Probability of having MDR-TB in TB patients | 0·006 | 0–0·01 | Beta | [14] |
| Relative risk of TB in the elderly | 2·25 | 2·20–2·31* | Lognormal | [1] |
| Probability of recurrence of DS-TB after TB treatment | 0·0684 | 0·0182–0·1785* | Beta | [14, 15] |
| Probability of recurrence of MDR-TB after TB treatment | 0·0836 | 0·0273–0·204* | Beta | [21] |
| Relative risk of reactivation rate with HIV infection | 9·9 | 8·7–11·3 | Lognormal | [23] |
| Relative risk of reactivation rate with poorly controlled diabetes mellitus | 1·7 | 1·5–2·2* | Lognormal | [23] |
| Relative risk of reactivation rate with chronic kidney disease | 2·4 | 2·1–2·8* | Lognormal | [23] |
| Prevalence of active TB with HIV infection | 0·0113 | 0·0099–0·0129 | Beta | [1, 17, 23] |
| Prevalence of active TB with poorly controlled diabetes mellitus | 0·0019 | 0·0017–0·0025 | Beta | [1, 17, 23] |
| Prevalence of active TB with chronic kidney disease | 0·0027 | 0·0024–0·0032 | Beta | [1, 17, 23] |
| Proportion of patients had the TST performed and read | 1 | − | − | Assumption |
| Efficacy of 9H chemoprophylaxis protocol | 0·8 | 0·6–0·9 | Beta | [13, 22] |
| Adherence rate of 9H chemoprophylaxis protocol | 0·365 | 0–1 | Beta | [16] |
| Completion rate of DS-TB treatment | 0·5 | 0·3–0·7 | Beta | Assumption |
| Completion rate of MDR-TB treatment | 0·5 | 0·3–0·7 | Beta | [21] |
| Probability of developing active TB from LTBI | 0·0015 | 0·0004–0·0039 | Beta | [23] |
| Probability of drug-related hepatotoxicity by 9H chemoprophylaxis | 0·021 | 0·01–0·04 | Beta | [12] |
| TB mortality | 0·366 | 0·2–0·5 | Beta | [19] |
| Sensitivity of TST for LTBI | 0·77 | 0·71–0·82* | Beta | |
| Sensitivity of TST for LTBI with HIV infection | 0·43 | 0·37–0·5 | Beta | |
| Sensitivity of TST for LTBI with diabetes mellitus | 0·73 | 0·64–0·78 | Beta | |
| Sensitivity of TST for LTBI with chronic kidney disease | 0·68 | 0·58–0·78 | Beta | [7, 26–29] |
| Specificity of TST for LTBI (BCG-vaccinated) | 0·59 | 0·46–0·73* | Beta | |
| Specificity of TST for LTBI (non-BCG-vaccinated) | 0·97 | 0·95–0·99* | Beta | |
| Sensitivity of QFT for LTBI | 0·84 | 0·81–0·87* | Beta | |
| Sensitivity of QFT for LTBI with HIV infection | 0·61 | 0·54–0·67* | Beta | |
| Sensitivity of QFT for LTBI with diabetes mellitus | 0·80 | 0·71–0·83 | Beta | |
| Sensitivity of QFT for LTBI with chronic kidney disease | 0·75 | 0·65–0·85 | Beta | |
| Specificity of QFT for LTBI | 0·99 | 0·98–1·00* | Beta | |
| Sensitivity of T-SPOT for LTBI | 0·89 | 0·86–0·91* | Beta | [8, 9, 26–29] |
| Sensitivity of T-SPOT for LTBI with HIV infection | 0·65 | 0·56–0·74* | Beta | |
| Sensitivity of T-SPOT for LTBI with diabetes mellitus | 0·84 | 0·71–0·87 | Beta | |
| Sensitivity of T-SPOT for LTBI with chronic kidney disease | 0·79 | 0·69–0·89 | Beta | |
| Specificity of T-SPOT for LTBI | 0·98 | 0·94–0·99* | Beta | |
| Sensitivity of QFT for active TB | 0·80 | 0·75–0·84* | Beta | |
| Specificity of QFT for active TB | 0·79 | 0·75–0·82* | Beta | [25] |
| Sensitivity of T-SPOT for active TB | 0·81 | 0·78–0·84* | Beta | |
| Specificity of T-SPOT for active TB | 0·59 | 0·56–0·62* | Beta | |
| Sensitivity of CXR for active TB | 0·70 | 0·59–0·82 | Beta | |
| Specificity of CXR for active TB | 0·60 | 0·52–0·63 | Beta | [30] |
| Cost ($US 2014, 1 $US = ¥105·8) | ||||
| QFT | 59·5 | 22·5–97·1 | [31–33] | |
| T-SPOT | 59·5 | 22·5–97·1 | ||
| TST | 15·1 | 10·9–31·5 | ||
| CXR | 35·6 | 17·8–71·2 | ||
| Smears, cultures and drug sensitivity test of sputum examination | 156·8 | 78·4–313·6 | n.a. | |
| 9H chemoprophylaxis | 1219·3 | 390·2–1817·2 | ||
| Treatment of drug-induced hepatitis by chemoprophylaxis | 11 689 | 5845–23 378 | ||
| Treatment of DS-TB for 6 months | 14 612 | 7306–29 224 | ||
| Treatment of MDR-TB | 1 89 457 | 94 729–378 914 | ||
| Average physician income per hour | 49·4 | 24·7–98·8 | ||
| Average nurse income per hour | 14·1 | 7·1–28·2 | n.a. | |
| Average income per hour for radiology technician | 23·8 | 11·9–47·6 | ||
| Average income per hour for laboratory technician | 21·3 | 10·7–42·6 | ||
| Utility | ||||
| Well | 1 | |||
| LTBI | 1 | |||
| LTBI taking LTBI treatment without complication | 0·95 | |||
| LTBI taking LTBI treatment with liver dysfunction | 0·85 | n.a. | [34, 35] | |
| DS-TB during treatment and before | 0·80 | |||
| MDR-TB during treatment and before | 0·58 | |||
| Dead | 0 | |||
* 95% confidence interval.
BCG, Bacillus Calmette-Guérin; CXR, chest X-ray examination; DS-TB, drug-sensitive tuberculosis; IGRA, interferon-gamma release assay; LTBI, latent tuberculosis infection; MDR-TB, multidrug-resistant tuberculosis; QFT, QuantiFERON®-TB Gold In-Tube; TB, tuberculosis; T-SPOT, T-SPOT®.TB; TST, tuberculin skin test; 9H, 9-month isoniazid.