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Table 2 Optional Triage approaches and key characteristic assumptions

From: Modelling the impact of chest X-ray and alternative triage approaches prior to seeking a tuberculosis diagnosis

Triage label

Description of triage approach

Sensitivity

Specificity

Additional cost per testb

T1- Base case

No triage

   

T2- Cough 1 week

Respiratory symptom of cough > 1 week [18]

88%

19%

US$0

T3 Cough 3 weeks

Respiratory symptom of cough > 3 weeks [18]

61%

51%

US$0

T4- Clinical Score

Scorecard based on aggregating scores assigned to respiratory symptoms including chest pain, cough, sputum expectoration, hemoptysis, night sweats, fever, shortness of breath and weight loss [18].

83%

52%

US$2

T5- ANN

Artificial Neural Network (ANN) based on using a multilayer perceptron (MLP) approach [19] to infer the probability of a patient having active pulmonary-TB from personal data and clinical symptoms i.e. age, gender, cough, fever, weight loss, smoker, night sweats, hospitalisation, chest pain, dyspnea, and hemoptysis.

98%a

32%a

US$2

T6- TPP (optimal)

A theoretical optimal target product profile (TPP) as proposed by Denkinger et al. [21]

95%

80%

US$2

T7- TPP (minimal)

A theoretical target product profile (TPP) with the minimum characteristics required to be useful as proposed by Denkinger et al. [21]

90%

70%

US$2

  1. athe sensitivity and specificity figures are taken from unpublished research in Brazil
  2. bThe additional cost per triage test is assumed to be low as the characteristics are those which clinicians will already consider today. An additional allowance (US$2) has been made if some computation is required in line with the costs proposed by Denkinger et al [20] for the TPP’s