Tests with best-estimated negative predictive values of at least 90% for latent tuberculosis infection or tuberculosis disease among adults over the probable range of prevalence
| LTBI among adults | TB disease among adults | |||||
| Prevalence (%) | Pre-test odds | Critical NLR* | Bivariate random effects model | Univariate random effects model | Bivariate random effects model | Univariate random effects model |
| Test, NLR (95% CI) | Test, NLR (95% CI) | Test, NLR (95% CI) | Test, NLR (95% CI) | |||
| 60–50 | 3/2–1/1 | 0.07–0.11 | T-SPOT.TB 0.10 (0.06 to 0.18) | T-SPOT.TB 0.09 (0.04 to 0.19) | T-SPOT.TB based on studies with mean or median age >47.1 years 0.11 (0.06 to 0.20) | T-SPOT.TB based on studies with mean or median age >47.1 years 0.11 (0.06 to 0.20) |
| QFT-G/QFT-G-IT(Japan) 0.11 (0.07 to 0.18) | QFT-G/QFT-G-IT(Japan) 0.11 (0.08 to 0.16) | |||||
| 50–40 | 1/1–2/3 | 0.11–0.17 | – | – | – | – |
| 40–30 | 2/3–3/7 | 0.17–0.26 | QFT-G/QFT-G-IT (non-Japan) 0.23(0.16 to 0.32) | QFT-G/QFT-G-IT (non-Japan) 0.24 (0.18 to 0.31) | – | – |
| 30–20 | 3/7–1/4 | 0.26–0.44 | – | – | – | – |
| 20–10 | 1/4–1/9 | 0.44–1.00 | TST-BCG (10 or 15 mm) 0.49 (0.32 to 0.76) | TST-BCG (10 or 15 mm) 0.51 (0.36 to 0.73) | – | – |
| TST-BCG (5 mm) 0.65 (0.33 to 1.29) | TST-BCG (5 mm) 0.70 (0.28 to 1.75) | |||||
Probable pre-test odds range from 1/9 to 11/9 for latent tuberculosis infection during tuberculosis contact investigation, and 2/3 to 3/2 for tuberculosis disease among patients with clinical manifestations. Japan and non-Japan in brackets denote results based on Japanese and non-Japanese studies, respectively. Tests that are suitable in settings with higher pre-test odds also work in settings with lower pre-test odds for better negative predictive values.
↵* Corresponding to negative predictive values of at least 90% (see mathematical equations in the Methods section).
LTBI, latent tuberculosis infection; PLR, positive likelihood ratio; NLR, negative likelihood ratio; QFT-G, QuantiFERON-TB Gold; QFT-G-IT, QuantiFERON-TB Gold in-Tube; TB, tuberculosis; TST-BCG (x mm), tuberculin skin test with cut-off at x mm among predominantly BCG-vaccinated subjects.