TB or Not TB: Study Highlights Role of TB Risk Scoring Tool in Diagnosis
Researchers have developed a TB risk scoring tool by reviewing past patient data to improve the ability to assess patients for potential TB infections. This tool was then integrated into the electronic health record with the label “TB or Not TB.” The findings are published in infection control and hospital epidemiology.
The tool helps clinicians assess, once their TB workup is complete and apparently negative, whether infection control precautions can be discontinued, ensuring accurate decisions for TB isolation, alleviating workload and improving patient experience.
The tool has been validated and is now in use at all Mass General Brigham. The research team joined with developers in clinical informatics and digital health to program the scoring model into the electronic health record in the form of a tool called “TB or Not TB.”
If a patient is identified as needing evaluation for TB, they are labeled as “TB-Risk,” prompting the correct isolation in the specialized hospital room and use of personal protective equipment. Once the healthcare provider believes, given the patient’s symptoms, test results and/or risk factors, that TB is no longer a possibility, they can use the TB or Not TB tool to determine if it is safe to discontinue isolation precautions.
In a rigorous analysis of TB evaluations across the Mass General Brigham system over six years, the tool correctly identified all instances in which TB infection was present and ensured that all those patients would remain safely isolated during their work up.
At the same time, the tool was able to identify about a quarter of cases where TB was highly unlikely.
Paper Cited:
Dugdale, C. M., Zachary, K. C., Craig, R. L., Doms, A., Germaine, L., Green, C. V., Gulbas, E., Hurtado, R. M., Hyle, E. P., Jerry, M. S., Lazarus, J. E., Maxfield, S., Paras, M., Swanson, K., & Shenoy, E. S. (2025). TB or not TB? Development and validation of a clinical decision support system to inform airborne isolation requirements in the evaluation of suspected tuberculosis. Infection control and hospital epidemiology, 1–9. Advance online publication. https://doi.org/10.1017/ice.2024.214
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