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Table 2 Utility of Determine TB-LAM point-of-care assay when used in combination with other diagnostic tests for HIV-associated tuberculosis (TB)

From: Point-of-care detection of lipoarabinomannan (LAM) in urine for diagnosis of HIV-associated tuberculosis: a state of the art review

Combination of diagnostic tests Advantages
Sputum smear microscopy + Determine TB-LAM · Incremental sensitivity.
  · Smear microscopy diagnoses most infectious patients
  · Determine TB-LAM provides rapid point-of-care diagnosis in those with high mortality risk permitting immediate initiation of TB treatment.
  · Low-cost.
Chest radiology + Determine TB-LAM · Determine TB-LAM can provide rapid point-of-care assessment of patients with abnormal chest radiographs, increasing the specificity for TB diagnosis.
  · Small incremental cost to radiology.
Sputum culture + Determine TB-LAM · Determine TB-LAM greatly expedites TB diagnosis in the sickest patients with highest mortality risk.
  · Small incremental cost to culture.
Sputum Xpert MTB/RIF + Determine TB-LAM · Determine TB-LAM adds little diagnostic sensitivity when used with Xpert MTB/RIF, but provides rapid point-of-care assessment. When Xpert is located in laboratories precluding same-day testing, Determine TB-LAM will expedite TB treatment in those with highest mortality risk, allowing immediate initiation of TB treatment.
  · Small incremental cost to Xpert MTB/RIF.