2016 Clinical Practice Guidelines for TB Diagnosis
The Centers for Disease Control and Prevention has released the 2016 Clinical Practice Guidelines for Diagnosis of Tuberculosis in Adults and Children. The guidelines were developed by the CDC, the American Thoracic Society and the Infectious Diseases Society of America, and they have been endorsed by the European Respiratory Society. The guidelines update the previous tuberculosis diagnostics guidelines published by ATS/CDC/IDSA in 2000.
The guidelines provide recommendations on the diagnosis of latent TB infection, pulmonary TB and extrapulmonary TB in adults and children. The 23 evidence-based recommendations include guidance for clinicians on how to employ newer tests to diagnose TB disease and latent TB infection, including interferon-gamma release assays (IGRAs) and molecular diagnostics. Although TB is less common in the United States than in other parts of the world, clinicians should consider testing patients who have a higher risk for TB infection, including patients who were born in or who frequently travel to countries where TB disease is common; patients who live or have lived in large group settings, such as homeless shelters or prisons and jails; and those with other risk factors, as described in the guidelines.
These recommendations were developed with the GRADE methodology, which involves structured literature review, systematic reviews and meta-analyses of combined data, and expert discussion to assess the certainty in the evidence and determine the strength of each recommendation.