What is evidence-based TB diagnosis?

There is great excitement in the TB scientific community over the introduction of new tools into TB control activities. The development of new tools is an important component of the Global Plan to Stop TB and the World Health Organization's new global Stop TB Strategy. While new tools offer great promise in medicine and public health, limited resources and the movement toward evidence-based guidelines require careful validation of new tools prior to their introduction for routine use. The world spends an estimated US$1 billion per year on diagnostics for TB. It is important to ensure that such expenditure is backed by strong evidence. Ideally, clinical and policy decisions must be guided by the totality of evidence on a given topic. This is particularly relevant for TB, where concerns have been raised about the lack of emphasis on evidence of effectiveness in some of the existing TB guidelines and policies.

High-quality evidence on TB diagnostics is critical for the development of evidence-based policies on TB diagnosis, and, ultimately, for effective control of the global TB epidemic. While primary diagnostic trials are needed to generate data on test accuracy and operational performance, systematic reviews provide the best synthesis of current evidence on any given diagnostic test. Although a large number of trials on TB diagnostics have been published, surprisingly, no systematic reviews were published until recently. In the past few years, more than 35 systematic reviews have been published on various TB tests. These reviews provide valuable insights into the accuracy of various tests. In addition to informing evidence-based TB diagnosis, systematic reviews have been helpful in informing policies and guidelines and development of research agendas.

Recognizing the growing importance of evidence-based TB diagnosis and policy making, the Stop TB Partnership's New Diagnostics Working Group has created a new subgroup on Evidence Synthesis for TB Diagnostics. This subgroup will support the development of new systematic reviews, facilitate the development and dissemination of evidence summaries on new diagnostics, and actively promote their use in guideline and policy development processes. This website is one of the contributions of the Evidence Synthesis subgroup.

For more information, please read the full article published in PLoS Medicine [Link].

For a recent review on TB diagnostics evidence, policy, practice and impact, [Link]

For information on how this website was developed, please read a paper in Expert Review of Molecular Diagnostics [Link].