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Controlling tuberculosis in an urban emergency department: a rapid decision instrument for patient isolation.

J T Redd and E Susser

Columbia University School of Public Health, New York, NY, USA.

OBJECTIVES: This study examined whether data routinely available in emergency departments could be used to improve isolation decisions for tuberculosis patients. METHODS: In a large emergency department in New York City, we compared the exposure histories of tuberculosis culture-positive and culture-negative patients and used these data to develop a rapid decision instrument to predict culture-positive tuberculosis. The screen used only data that are routinely available to emergency physicians. RESULTS: The method had high sensitivity (.96) and moderate specificity (.54). CONCLUSIONS: The method is easily adaptable for a broad range of settings and illustrates the potential benefits of applying basic epidemiologic methods in a clinical setting.

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