![]() ![]() We recommend performing an interferon-γ release assay (IGRA) rather than a tuberculin skin test (TST) in individuals 5 years or older who meet the following criteria: (1) are likely to be infected with Mtb, (2) have a low or intermediate risk of disease progression, (3) it has been decided that testing for LTBI is warranted, and (4) either have a history of BCG vaccination or are unlikely to return to have their TST read ( strong recommendation, moderate-quality evidence). Abbreviations: CXR, chest radiograph HIV, human immunodeficiency virus LTBI, latent tuberculosis infection Mtb, Mycobacterium tuberculosis RR, TB, tuberculosis TST, tuberculin skin test. These groups are concordant with current recommendations for the interpretation of the tuberculin skin test (American Thoracic Society, Targeted tuberculin testing and treatment of latent tuberculosis infection. Recommendations were formulated for each of the 3 groups illustrated above. In developing a diagnostic approach for the evaluation of those with suspected LTBI, we recommend the clinician weigh the likelihood of infection, the likelihood of progression to tuberculosis if infected, and the benefit of therapy (Horsburgh and Rubin, Clinical practice: latent tuberculosis infection in the United States. Paradigm for evaluation of those with latent tuberculosis infection (LTBI) based on risk of infection, risk of progression to tuberculosis, and benefit of therapy. Policymaking will require substantial debate and involvement of various stakeholders. The recommendation can be adopted as policy in most situations. ![]() Decision aids may be useful in helping individuals to make decisions consistent with their values and preferences. Recognize that different choices will be appropriate for individual patients and that you must help each patient arrive at a management decision consistent with his or her values and preferences. Formal decision aids are not likely to be needed to help individuals make decisions consistent with their values and preferences. Adherence to this recommendation according to the guideline could be used as a quality criterion or performance indicator. Most individuals should receive the intervention. The majority of individuals in this situation would want the suggested course Most individuals in this situation would want the recommended course of action, and only a small proportion would not. ![]()
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