CONTROLLING TUBERCULOSIS IN AN URBAN EMERGENCY DEPARTMENT - A RAPID DECISION INSTRUMENT FOR PATIENT ISOLATION

Objectives. This study examined whether data routinely available in em ergency departments could be used to improve isolation decisions for t uberculosis 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 p hysicians. Results. The method had high sensitivity (.96) and moderate specificity (.54).Conclusions. The method is easily adaptable for a b road range of settings and illustrates the potential benefits of apply ing basic epidemiologic methods in a clinical setting.