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Description

Solari et al reported a clinical prediction rule for the diagnosis of pleural tuberculosis in a patient in Peru. This can help to identify a patient who can be started on therapy without a pleural biopsy. The authors are from the Institute of Tropical Medicine Antwerp, Instituto Nacional de Salud, Universidad Peruana de Ciencias Aplicados, Hospital Nacional Hipolito Unanue and Ghent University.


Patient selection: exudative pleural effusion

 

Parameters:

(1) age in years

(2) sex

(3) history of contact with a patient with tuberculosis

(4) lymphadenopathy

(5) adenosine deaminase (ADA) in pleural fluid IU/L

 

Parameter

Findiing

Points

age in years

 

(-0.7 * (age))

sex

male

12

 

female

0

history of TB contact

no

0

 

yes

13

lymphadenopathy

no

0

 

yes

-19

pleural fluid ADA

 

0.4 * (ADA)

 

score =

= SUM(points for the 5 parameters) + 70

 

Interpretation:

minimum score: around -20

maximum score: around 125

A score >= 60 is associated with pleural tuberculosis.

A pleural fluid ADA >= 30 IU/L was associated with pleural tuberculosis.

 

Performance:

The area under the ROC curve is 0.92.


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