Document 0172
 DOCN  M95A0172
 TI    Bronchoalveolar lavage in pulmonary tuberculosis: a decision analysis
       approach.
 DT    9510
 AU    Mohan A; Pande JN; Sharma SK; Rattan A; Guleria R; Khilnani GC;
       Department of Medicine, All India Institute of Medical Sciences,; New
       Delhi.
 SO    QJM. 1995 Apr;88(4):269-76. Unique Identifier : AIDSLINE MED/95316460
 AB    We assessed the utility of bronchoalveolar lavage (BAL) in the diagnosis
       of pulmonary tuberculosis (PTB) in 50 consecutive HIV-negative patients
       with clinical and radiographic findings suggestive of PTB, but with
       negative microscopy for acid-fast bacilli (AFB) on sputum smear.
       Patients were grouped, using a scoring system, into relative likelihoods
       of having PTB (I-IV, in descending probability). Patients were started
       on anti-tuberculosis treatment according to the BAL results.
       Bacteriological diagnosis of PTB was confirmed in 22/50 BAL; 11 (91.6%),
       seven (37%) and four (40%) of groups I-III, respectively. In 13 cases,
       an early diagnosis of PTB was made by positive microscopy for AFB on
       BAL; an alternative diagnosis was made in six cases (bacterial pneumonia
       4, carcinoma 2). A decision analysis model was created to assess the
       overall utility of BAL. This suggested that in a region of high PTB
       prevalence, and when the clinical diagnosis of PTB is likely, empirical
       treatment is the best course of action, with BAL being reserved for
       further investigation of non-responders. Early BAL should be considered
       when the diagnosis of PTB is uncertain.
 DE    Adolescence  Adult  Aged  Aged, 80 and over  Bronchoalveolar Lavage
       Fluid/*MICROBIOLOGY  *Decision Support Techniques  Female  Human  Male
       Middle Age  Prevalence  Tuberculosis, Pulmonary/*DIAGNOSIS/DRUG
       THERAPY/EPIDEMIOLOGY  JOURNAL ARTICLE

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