EDITORIAL
Annals of Internal Medicine
Celebrating the ACP Centennial: From the Annals Archive
D
uring the 2015 centennial year of the American College of Physicians, publisher of Annals of Internal Medicine, Annals editors will link an article in each issue with an earlier paper from our archives addressing the same disease or clinical question. We hope our readers find this interesting and we welcome comments, especially from physicians who were practicing at the time of publication of the original paper who might offer insight into the impact of the earlier paper on their knowledge or practice.
time, the prevalence of TB in the United States had reached historic lows. The authors performed a retrospective study matching the results of nearly 10 000 TB smears and cultures and finding that smears had as many false-positive results as true-positive results. The study is notable for its application of the Bayes theorem as well as its consideration of “the problem of rising health-care costs and the question of whether screening tests truly serve the purpose for which they were designed.”
In this issue, Liu and colleagues (1) demonstrate that in a tuberculosis (TB) screening program for immigrants and refugees bound for the United States, most coming from countries with a high prevalence of TB, performing a TB culture even when the TB smear result was negative substantially improved detection of clinical TB compared with a strategy of performing a TB culture only in those with a positive smear result. Therefore, the TB smear produced false-negative results too often to be of value as a screening test in this setting. In contrast, in a 1975 article in Annals, Boyd and Marr (2) investigated what seemed to be an unusually high number of false-positive TB smear results among patients at Barnes Hospital (St. Louis, Missouri). At that
Deborah Cotton, MD, MPH Deputy Editor Ann Intern Med. 2015;162:452. doi:10.7326/M15-0125
References 1. Liu Y, Posey DL, Cetron MS, Painter JA. Effect of a culture-based screening algorithm on tuberculosis incidence in immigrants and refugees bound for the United States. A population-based crosssectional study. Ann Intern Med. 2015;162:420-8. doi:10.7326/M142082 2. Boyd JC, Marr JJ. Decreasing reliability of acid-fast smear techniques for detection of tuberculosis. Ann Intern Med. 1975;82:48992. [PMID: 1091188] doi:10.7326/0003-4819-82-4-489
452 © 2015 American College of Physicians
Downloaded From: http://annals.org/ by a Penn State University Hershey User on 05/28/2015
Annals of Internal Medicine
Celebrating the ACP Centennial: From the Annals Archive
D
uring the 2015 centennial year of the American College of Physicians, publisher of Annals of Internal Medicine, Annals editors will link an article in each issue with an earlier paper from our archives addressing the same disease or clinical question. We hope our readers find this interesting and we welcome comments, especially from physicians who were practicing at the time of publication of the original paper who might offer insight into the impact of the earlier paper on their knowledge or practice.
time, the prevalence of TB in the United States had reached historic lows. The authors performed a retrospective study matching the results of nearly 10 000 TB smears and cultures and finding that smears had as many false-positive results as true-positive results. The study is notable for its application of the Bayes theorem as well as its consideration of “the problem of rising health-care costs and the question of whether screening tests truly serve the purpose for which they were designed.”
In this issue, Liu and colleagues (1) demonstrate that in a tuberculosis (TB) screening program for immigrants and refugees bound for the United States, most coming from countries with a high prevalence of TB, performing a TB culture even when the TB smear result was negative substantially improved detection of clinical TB compared with a strategy of performing a TB culture only in those with a positive smear result. Therefore, the TB smear produced false-negative results too often to be of value as a screening test in this setting. In contrast, in a 1975 article in Annals, Boyd and Marr (2) investigated what seemed to be an unusually high number of false-positive TB smear results among patients at Barnes Hospital (St. Louis, Missouri). At that
Deborah Cotton, MD, MPH Deputy Editor Ann Intern Med. 2015;162:452. doi:10.7326/M15-0125
References 1. Liu Y, Posey DL, Cetron MS, Painter JA. Effect of a culture-based screening algorithm on tuberculosis incidence in immigrants and refugees bound for the United States. A population-based crosssectional study. Ann Intern Med. 2015;162:420-8. doi:10.7326/M142082 2. Boyd JC, Marr JJ. Decreasing reliability of acid-fast smear techniques for detection of tuberculosis. Ann Intern Med. 1975;82:48992. [PMID: 1091188] doi:10.7326/0003-4819-82-4-489
452 © 2015 American College of Physicians
Downloaded From: http://annals.org/ by a Penn State University Hershey User on 05/28/2015
