Fournet et al developed a score to screen a prisoner for tuberculosis. This can be used to help identify patients who should have additional tests for tuberculosis. The authors are from Universite Pierre et Marie Curie in Paris, Escola Nacional de Saude Publica in Fiocruz (Brazil), and the administration of prisons for Rio de Janeiro.
Parameters:
(1) fever
(2) chest pain
(3) body mass index (BMI)
(4) history of treatment for tuberculosis
(5) employment status
(6) smoking status
body mass index in kg per square meter =
= (body weight) / ((height in square meter)^2)
Parameter
Finding
Points
fever
absent
0
present
1
chest pain
absent
0
present
1
body mass index
>= 20 kg per sq meter
0
< 20 kg per square meter
1
history of therapy for TB
absent
0
present
1
employment status
employed
0
unemployed
1
smoking status
nonsmoker
0
smoker
1
total score =
= SUM(points for these 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 6
• A patient with a score >= 2 should be evaluated for tuberculosis.
Performance:
• The sensitivity was 74% and specificity 67%.
• The positive predictive value in the study was low (around 10%), possibly because of a low prevalence of tuberculosis in the study population (4.6%).
• The negative predictive value was around 98% at a pretest prevalence of 4.6%.
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