Article

The tuberculin skin test: a comparison of ruler and calliper readings.

South African Tuberculosis Vaccine Initiative, University of Cape Town, Cape Town, South Africa.
The international journal of tuberculosis and lung disease: the official journal of the International Union against Tuberculosis and Lung Disease (impact factor: 2.73). 10/2010; 14(10):1266-71. pp.1266-71
Source: PubMed

ABSTRACT The Mantoux tuberculin skin test (TST) is widely used to diagnose latent infection with Mycobacterium tuberculosis. TST skin induration may be measured either by a transparent ruler or by a pair of callipers. We hypothesised that the type of instrument used may affect the reading.
To determine whether variability in Mantoux TST measurement is affected by the type of reading instrument.
A TST (Mantoux method) was performed among healthy adolescents. The indurations were read with among ruler and calliper by two independent readers. Limits of agreement and Kappa (κ) scores at TST positivity cut-off points were calculated. A Bland-Altman graph was constructed.
The 95% limits of agreement between instruments ranged from -5 mm to 3 mm. The limits of agreement between readers ranged from -5 mm to 4 mm. κ scores between instruments were respectively 0.7 and 0.8 at 15 mm and 10 mm cut-offs.
The variability between readers of TST indurations is not influenced by changing the reading instrument.

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Keywords

Bland-Altman graph
 
callipers
 
diagnose latent infection
 
healthy adolescents
 
independent readers
 
instruments
 
Mantoux method
 
Mantoux TST measurement
 
Mantoux tuberculin skin test
 
Mycobacterium tuberculosis
 
readers
 
reading instrument
 
transparent ruler
 
TST
 
TST indurations
 
TST positivity cut-off points
 
TST skin induration
 
variability
 
κ scores