New Tests for the Diagnosis of Latent Tuberculosis Infection

Abstract

Letters6 November 2007New Tests for the Diagnosis of Latent Tuberculosis InfectionDick Menzies, MD, MSc and Madhukar Pai, MD, PhDDick Menzies, MD, MScFrom Montreal Chest Institute, McGill University, Montréal, Québec H2X 2P4, Canada.Search for more papers by this author and Madhukar Pai, MD, PhDFrom Montreal Chest Institute, McGill University, Montréal, Québec H2X 2P4, Canada.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-147-9-200711060-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We agree with Drs. Kunst and Khan that the lack of a proper gold standard is a fundamental problem of all cross-sectional studies of diagnostic tests for latent tuberculosis infection. We state this problem explicitly several times in our paper. We believe that longitudinal studies following cohorts of persons with positive or negative test results will be most valuable, because the later development of active tuberculosis is the only certain indicator of the presence of latent tuberculosis infection. Because treatment reduces incidence of disease, ideally, such cohorts of individuals would be untreated, which poses serious ethical issues. However, ...