Background
Research question
Objectives
Primary objective
Secondary objectives
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To describe the timing of prescription of the trial-of-antibiotics in TB diagnostic algorithms as reported in included articles
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To describe the type, duration, and number of prescriptions of routine oral antibiotics
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To establish how response to trial-of-antibiotics is interpreted and the decision-making process following positive or negative results
Methods
Eligibility criteria
Population | Adult patients with respiratory symptoms |
Index test | Trial-of-antibiotics (any course of broad-spectrum antimicrobial given with the goal of ruling out TB in a symptomatic adult) |
Reference test | Any mycobacteriology test (we expect smear microscopy, smear microscopy using a fluorescent microscope, Cepheid GeneXpert, and mycobacterial culture) |
Outcome | Proportion of mycobacteriology-positive or mycobacteriology-negative participants correctly identified by trial-of-antibiotics (sensitivity and specificity) |
Design | Cross-sectional, cohort, and randomised controlled studies |
Information sources and search strategy
Search in Ovid MEDLINE | |
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Search line | Search terms |
Part 1 | Defining study population |
1. | exp Tuberculosis/ |
2. | tuberculosis.mp. |
3. | (suspect* adj3 (TB or Tuberculosis)).mp. |
4. | (presumpt* adj3 (TB or Tuberculosis)).mp. |
5. | (probabl* adj3 (TB or Tuberculosis)).mp. |
6. | exp Cough/ |
7. | tb.mp. |
8. | (suspect* adj3 (TB or Tuberculosis)).mp. |
9. | or/1-8 |
Part 2 | Defining study intervention |
1. | (Antibiotic* adj3 trial).mp. |
2. | antibiotic*.mp. |
3. | Anti-Bacterial Agents/ |
4. | (oral* adj3 antibiotic*).mp. |
5. | (amox?cillin or erythromycin or azithromycin or doxycyclin* or Vibramycin or clavulanic acid or co-amoxiclav).mp. |
6. | or/10-14 |
Part 3 | Defining study outcome |
1. | exp “Sensitivity and Specificity”/ |
2. | sensitivity.mp. |
3. | specificity.mp. |
4. | accuracy.mp. |
5. | exp “Predictive Value of Tests”/ |
6. | ((positive or negative) adj2 predictive value).mp. |
7. | (ppv or npv).mp. |
8. | or/16-22 |
Part 4 | Subject combinations |
1. | 9 and 15 (population and intervention) |
2. | 23 and 24 (Population and intervention and outcome) |
Part 5 | Applying pre-defined limits |
1. | limit 25 to yr=“1993 -Current” |