Decision Analysis for Tuberculosis Preventive Treatment in Nursing Homes

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Abstract
There are differing opinions on whether or not to use isoniazid (INH) preventive treatment in older people with significantly reactive ("positive") tuberculin skin tests and fibrotic changes on chest roentgenogram. To assist the clinician facing this decision, a Decision Analysis was completed. Using available data, it is seen that using INH will not have much impact on five-year survivorship, but will reduce the number of tuberculosis disease cases, thus having an overall beneficial impact. Where tuberculosis incidence is higher, the benefit of INH preventive treatment is correspondingly higher.