Related Experiment Video
Updated: Aug 11, 2025
09:57
System for Efficacy and Cytotoxicity Screening of Inhibitors Targeting Intracellular Mycobacterium tuberculosis
Published on: April 5, 2017
8.7K
The therapeutic threshold in clinical decision-making for TB
Madeleine L de Rooij1, Lutgarde Lynen1, Tom Decroo1
1Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, 2000, Belgium.
International Health
|February 6, 2023
Summary
Diagnostic uncertainty in tuberculosis (TB) management necessitates clear decision-making thresholds. This review highlights that estimates for the therapeutic threshold in pulmonary TB vary significantly based on the chosen estimation method.
Area of Science:
- Public Health
- Infectious Diseases
- Clinical Decision-Making
Background:
- Tuberculosis (TB) control faces challenges due to diagnostic tool limitations, leading to common diagnostic uncertainty.
- Clinical decision-making is crucial for determining TB treatment, guided by therapeutic, test, and test-treatment thresholds.
Purpose of the Study:
- To review and summarize existing literature on methods for estimating the therapeutic threshold specifically applied to TB diagnosis.
- To analyze the discrepancies in therapeutic threshold estimates for pulmonary TB based on different methodological approaches.
Main Methods:
- Literature review focusing on studies that estimated therapeutic thresholds for TB diagnosis.
- Categorization of estimation methods into prescriptive (calculation-based) and descriptive (practice-based) approaches.
Main Results:
- Only five studies were identified that estimated the therapeutic threshold for TB diagnosis.
- Descriptive methods yielded higher therapeutic threshold estimates for pulmonary TB (20%-50%) compared to prescriptive calculations (2%-3%).
Conclusions:
- Estimates of the therapeutic threshold for pulmonary TB are highly dependent on the methodology employed.
- Further development of clinician-friendly, unbiased methods is needed to establish context-specific, agreed-upon therapeutic thresholds for TB management.
More Related Videos
Related Concept Videos
01:26Pulmonary Tuberculosis IV
186
Tuberculosis, more commonly referred to as TB, is an infectious disease stemming from Mycobacterium tuberculosis. While it primarily impacts the lungs, TB can also affect other body areas. Given its severity and global impact, timely and accurate diagnosis is crucial for controlling its spread and improving patient outcomes.
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...
186
01:28Pulmonary Tuberculosis V
224
Medical management of tuberculosis (TB) patients involves a comprehensive approach that includes diagnosis, treatment, and monitoring. The specific strategies can vary depending on the type of tuberculosis (latent or active), the patient's overall health status, and other considerations.
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the...
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the...
224
01:31Pulmonary Tuberculosis III
406
Tuberculosis (TB) is a contagious infection primarily affecting the lung parenchyma but which can also affect other body parts. TB can be classified based on disease development, presentation, and the affected anatomical site.
The first classification is based on the development of the disease, and it includes the following categories:
The first classification is based on the development of the disease, and it includes the following categories:
406
01:13Therapeutic Index
4.5K
The therapeutic index of a drug is a key parameter in pharmacology that quantifies the relative safety of a drug by calculating the ratio between the dose that causes toxicity in half the population (50%) to the dose that proves to be effective for half the population (50%). It provides a spectrum of doses for a particular drug ranging from effective to potentially toxic. To illustrate, consider an anticoagulant agent like warfarin. It possesses a narrow window within its therapeutic index to...
4.5K
01:29Pulmonary Tuberculosis I
297
Tuberculosis, often called TB, is a contagious illness primarily caused by Mycobacterium tuberculosis. It mainly affects the lung parenchyma but can also impact other body parts.
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
297
01:28Pulmonary Tuberculosis II
292
Tuberculosis, or TB, is a bacterial infectious disease caused by Mycobacterium tuberculosis. While its primary impact is on the lungs, leading to pulmonary tuberculosis, it can also affect various other organs, a condition referred to as extrapulmonary tuberculosis.
Here is a detailed explanation of its pathophysiology:
Transmission: The process begins when a person inhales droplet nuclei containing M. tuberculosis. These are typically released into the air when an individual with pulmonary or...
Here is a detailed explanation of its pathophysiology:
Transmission: The process begins when a person inhales droplet nuclei containing M. tuberculosis. These are typically released into the air when an individual with pulmonary or...
292