Fournet et al modified the WHO score for screening a prisoner for tuberculosis (see above). This can be used to help identify patients who should have additional tests for tuberculosis. The authors are from Universite Pierre et Marie Curie in Paris, Escola Nacional de Saude Publica in Fiocruz (Brazil), and the administration of prisons for Rio de Janeiro.
Parameters:
(1) cough
(2) chest pain
(3) body mass index (BMI)
(4) history of being treated for tuberculosis
body mass index in kg per square meter =
= (body weight) / ((height in square meter)^2)
Parameter
Finding
Points
duration of cough
<= 3 weeks
0
> 3 weeks
1
chest pain
absent
0
present
1
body mass index
>= 20 kg per square meter
0
< 20 kg per square meter
1
history of being treated for TB
absent
0
present
1
modified score =
= SUM(points for these 4 parameters)
Interpretation:
• minimum modified score: 0
• maximum modified score: 4
• A score >= 1 identified a prisoner who should be screened for tuberculosis.
Performance:
• The modified score had a sensitivity of 72% and specificity of 60%.
• It performed better than the original WHO score but was had a low positive predictive value (around 8%). The high negative predictive value makes it attractive to exclude patients from further testing.
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