Evidence map›Paper›PMID 41184792›Full record

SynthesisBMC infectious diseases2025

Repeat testing or additional tuberculin skin tests for management of indeterminate results of interferon-gamma release assays: a systematic review and meta-analysis.

Xin Guo, Yan Dong, Shunli Cai, Yuan Xia, Yingchen Zhou, Xuesong Chen, Yan Dong, Hongbo Chen, Jian He, Chao Song and 3 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Xin Guo *Faculty of Life Science and Technology & The Affliated Anning First People's Hospital, Kunming University of Science and Technology, Kunming, 650302, China.
Yan Dong *Department of Pain Medicine, The Affiliated Anning First People's Hospital of Kunming University of Science and Technology, Kunming, 650302, Yunnan Province, China.
Shunli CaiFaculty of Life Science and Technology & The Affliated Anning First People's Hospital, Kunming University of Science and Technology, Kunming, 650302, China.
Yuan XiaSchool of Basic Medical Sciences, Kunming Medical University, Kunming, 650051, Yunnan Province, China.
Yingchen ZhouThe School of Medicine, Kunming University, Kunming, 650214, Yunnan Province, China.
Xuesong ChenDepartment of Pain Medicine, The Affiliated Anning First People's Hospital of Kunming University of Science and Technology, Kunming, 650302, Yunnan Province, China.
Yan DongDepartment of Pain Medicine, The Affiliated Anning First People's Hospital of Kunming University of Science and Technology, Kunming, 650302, Yunnan Province, China.
Hongbo ChenDepartment of Pulmonary and Critical Care Medicine, The Affiliated Anning First People's Hospital of Kunming University of Science and Technology, Kunming, 650302, Yunnan Province, China.
Jian HeDepartment of Pulmonary and Critical Care Medicine, The Affiliated Anning First People's Hospital of Kunming University of Science and Technology, Kunming, 650302, Yunnan Province, China.
Chao SongDepartment of Pain Medicine, The Affiliated Anning First People's Hospital of Kunming University of Science and Technology, Kunming, 650302, Yunnan Province, China.
Chengguo ZhanDepartment of Laboratory Medicine, The Affiliated Anning First People's Hospital of Kunming University of Science and Technology, Kunming, 650302, Yunnan Province, China.
Yungui TuDepartment of Laboratory Medicine, The Affiliated Anning First People's Hospital of Kunming University of Science and Technology, Kunming, 650302, Yunnan Province, China. tuyungui@163.com.
Guozhong ZhouFaculty of Life Science and Technology & The Affliated Anning First People's Hospital, Kunming University of Science and Technology, Kunming, 650302, China. 20220247@kust.edu.cn.

Funding

the Special Project "Spring City Plan" Famous Doctor C202012016the Talent Project of Kunming Health Science and Technology 2022-SW [Leading Talents]-001
6 · The paper itself

Abstract

backgroundInterferon-gamma release assays (IGRAs) are widely used for detecting latent tuberculosis infection (LTBI). However, these tests can yield indeterminate results, posing challenges for clinical management. The management of these indeterminate outcomes varies, creating uncertainty in clinical practice. This study systematically evaluates the effectiveness of repeat IGRA testing versus additional tuberculin skin testing (TST) in resolving indeterminate IGRA results during LTBI screening.

methodsWe conducted a systematic review and meta-analysis, searching PubMed, Embase, Web of Science, and the Cochrane Library databases on May 18, 2024, without start date or language restrictions. Studies were included if they screened for LTBI in healthy or high-risk populations using IGRA, reported indeterminate results, and managed these results with repeat IGRA testing and/or additional TST. A random-effects model was used to calculate pooled results.

resultsA total of 59 studies were included in this analysis. Among these, 40 studies assessed the use of additional TST in individuals with indeterminate IGRA results, yielding a pooled confirmation rate of 98.6% (95% CI: 96.2-99.8%). Additionally, 27 studies examined repeat IGRA testing, which resulted in a pooled confirmation rate of 68.9% (95% CI: 57.0-79.6%). Furthermore, eight studies evaluated both TST and repeat IGRA testing, with the pooled confirmation rate for the TST being 93.7% (95% CI: 78.7-99.9%), higher than the pooled confirmation rate for repeat testing at 76.5% (95% CI: 44.6-97.1%). However, there was no statistically significant difference in the confirmation rates between the two testing methods (OR = 2.13, 95% CI: 0.47-9.76).

conclusionsIn managing indeterminate IGRA results during LTBI screening, head-to-head studies show no significant difference in confirmation rates between additional TST and repeat IGRA. Across nearly 60 studies, additional TST tends to have a slightly higher confirmation rate, though the difference is not statistically significant. Clinically, for patients with an initial indeterminate IGRA who are immunocompetent, with convenient sample collection or a need for rapid results, additional TST may help achieve more reliable outcomes. Selection of follow-up testing should consider the cause of indeterminate results, feasibility, and risk of patient loss to follow-up.

Indexed as

Interferon-gamma Release TestsLatent TuberculosisTuberculin TestHumansMass ScreeningIndeterminateInterferon-gamma release assayLatent tuberculosis infectionMeta-analysisTuberculin skin tests

Identifiers

PMID41184792
PMCPMC12581443

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.