Recommendation ID

In people with suspected TB, what is the relative clinical and cost effectiveness of universal and
risk-based use of rapid nucleic acid amplification tests?

Any explanatory notes
(if applicable)

Why this is important
The guideline committee noted that there were 2 possible approaches to using rapid nucleic acid
amplification tests for suspected TB. The current approach is to use them only if TB is strongly
suspected and rapid information about mycobacterial species would alter the person's care.
Another approach is to use them in anyone with a possible diagnosis of TB. There is a trade-off
between ensuring that all people with active TB are diagnosed and avoiding a large number of false
positives, which leads to unnecessary treatment. This trade-off may lead to differences in the cost
effectiveness of each approach. NICE's systematic review of the diagnosis of active TB did not
identify any robust evidence on this, nor did the health technology assessment on using nucleic acid
amplification tests to detect drug resistance. Cost-effectiveness studies are needed to improve
understanding in this area.

Source guidance details

Comes from guidance
Date issued
January 2016

Other details

Is this a recommendation for the use of a technology only in the context of research? No  
Is it a recommendation that suggests collection of data or the establishment of a register?   No  
Last Reviewed 30/09/2019