The accuracy of Aziza’s scoring system in limited slice non-enhanced thoracic CT for the diagnosis of adult pulmonary tuberculosis
Abstract: Tuberculosis (TB) is
still a major cause of morbidity and mortality in Indonesia. Thus, a fast and
accurate method in diagnosing pulmonary TB (PTB) is needed, especially in adult
smear-negative-TB cases. The purpose of this study was to determine the
accuracy of a novel scoring system (Aziza’s score) using clinical data and
characteristic abnormalities that are found in the limited slice non-enhanced
thoracic CT.
Methods: This was a prospective cross-sectional study. A limited slice
non-enhanced thoracic CT was performed to establish a diagnosis of PTB in
patients with suspected PTB and to assess the diagnostic value of the scoring
system. A reference standard used in this study was the clinical expertise of
two pulmonologists. The scoring system was analyzed using bivariate and
multivariate Cox regression analysis.
Results: 84 of 130 suspected PTB patients were diagnosed as PTB. They
were diagnosed based on pulmonary characteristic abnormalities that were found
in the limited slice non-enhanced thoracic CT. The scoring system was analyzed
using bivariate and multivariate Cox regression analysis. The total scores
which were equal to or more than 29 could diagnose PTB with the accuracy of
96.1% (95% CIs=91.3–98.3), sensitivity of 96.5% (95% CIs=90.1–98.8), and
specificity of 95.6% (95% CIs=90.1–98.8), This novel scoring method was name as
an Aziza’s scoring system.
Conclusion: Aziza’s scoring system performed in the limited slice
non-enhanced thoracic CT has a higher accuracy compared to the reference
standard for the diagnosis of adult PTB.
Keywords: adult PTB; Aziza’s
scoring system; limited slice non-enhanced thoracic CT
Author: Aziza Icksan, Arif
Faisal, Elisna Syahruddin
Journal Code: jpkedokterangg170188
