Nemcek A A, Forrest J V, Barrett-Connor E
Am J Infect Control. 1985 Apr;13(2):52-6. doi: 10.1016/0196-6553(85)90082-3.
On the basis of limited benefit in relation to cost, mass radiographic screening for tuberculosis was challenged and abandoned in the 1970s. In the 1980s the value of such periodic screening of hospital employees with known positive tuberculin reactions was queried on the same grounds but without comparable data. We report here the results of 11 years of radiographic screening of tuberculin-positive employees of a university hospital. Although 3900 chest films were obtained at considerable cost, only one proved and six suspect cases of tuberculosis were detected, all of which were symptomatic. Even in the absence of symptoms all could have been identified by other screening criteria, five on the basis of recent tuberculin conversion and two as tuberculin-positive new employees. These data support the recent statement that periodic chest roentgenograms of hospital employees with known positive reactions to tuberculin skin testing are not justified.
基于成本效益有限，20世纪70年代，肺结核的大规模放射学筛查受到质疑并被放弃。20世纪80年代，同样基于成本效益问题，有人对定期筛查已知结核菌素反应呈阳性的医院员工的价值提出质疑，但缺乏可比数据。我们在此报告一所大学医院对结核菌素呈阳性的员工进行11年放射学筛查的结果。尽管花费高昂获得了3900张胸片，但仅检测出1例确诊病例和6例疑似肺结核病例，所有病例均有症状。即使没有症状，所有病例也都可以通过其他筛查标准确诊，其中5例基于近期结核菌素血清转化，2例为结核菌素呈阳性的新员工。这些数据支持了近期的一项声明，即对已知结核菌素皮肤试验呈阳性反应的医院员工进行定期胸部X光检查是不合理的。
