Beyond accuracy: creating a comprehensive evidence base for TB diagnostic tools [State of the art]
Abstract:The need for a strong and comprehensive evidence base to support decision making with regard to the implementation of new and improved diagnostic tools and approaches has been highlighted by a number of stakeholders; these include members of the New Diagnostics Working Group (NDWG) and the Subgroup for Introducing New Approaches and Tools of the Stop TB Partnership. To compile such evidence in a systematic manner, we have developed an impact assessment framework (IAF) which links evidence on inputs to outcomes.
The IAF comprises five interconnected layers: effectiveness analysis, equity analysis, health systems analysis, scale-up analysis and policy analysis. It can be used by new diagnostics developers and other interested research teams to collect as much policy-relevant data as possible prior to, during and after the demonstration phase of tool development. The evidence collated may be used by international and national policy makers to support adoption, implementation and scale-up decisions. The TREAT TB (Technology, Research, Education and Technical Assistance for TB) initiative uses the IAF in its operational research and field evaluations of new tools and approaches for TB diagnosis. It has also been incorporated into the NDWG's recent publication: ‘Pathways to better diagnostics for tuberculosis: a blueprint for the development of TB diagnostics’. This article describes the IAF and the process of improving it and suggests next steps in overcoming the challenges in its implementation.
Document Type: Review Article
Affiliations: 1: Liverpool School of Tropical Medicine, Liverpool, UK 2: International Union Against Tuberculosis and Lung Disease, Paris, France 3: Arkhangelsk Regional Anti-tuberculosis Dispensary, Arkhangelsk, Russian Federation 4: Desmond Tutu TB Centre, Cape Town, South Africa 5: National Health Laboratory Services, Johannesburg, South Africa 6: Rede TB, Brasília, Brazil
Publication date: December 1, 2010
The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.
Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website
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