In a new preprint (NOT PEER REVIEWED) we continue to explore the challenge of overtreatment in community screening. It seems the benefits of TB treatment far outweigh the harms, especially once we accept that sputum culture is not perfect. Important food for thought. www.medrxiv.org/content/10.1...

Xpert MTB/RIF® cycle threshold as a marker of TB disease severity; Implications for TB treatment stratification ✅ Just Accepted #IDSky 🔗 https://bit.ly/3WbLI1G

This paper has now been peer reviewed and is available open access at CID.

apropos of nothing

Nutritional status is a key determinant of TB. In this updated systematic review and dose-response meta-analysis (43 cohorts inc > 26 million people) we redefined the relationship between body mass index (BMI) and TB. doi.org/10.1093/ije/...

At a time when global resources for #TB research, development, prevention, and care are limited, which interventions should be prioritised in high burden settings? 📢 Our new pre-print compares the impact, cost, and cost-effectiveness of 9 TB interventions in 3 countries. 1/n bit.ly/3V3vXth

Academia may not give you job security, flexibility, or wealth, but it will let you unexpectedly connect to eduroam in foreign cities

I really dislike how science has started calling almost any fancy computational technique AI. 🧪 The framing of this entire article makes it sound like a benevolent AI independently made these drugs. That is *pure fantasy*. Instead: a team of scientists made a machine learning model for a study.

⚡️New preprint (not peer-reviewed)⚡️ In the SaDAPT trial with people with #HIV and #tuberculosis symptoms in 🇲🇼🇱🇸, we investigated if antiretroviral therapy should be initiated immediately, or delayed until TB results available. ssrn.com/abstract=523... Outcomes (incl. IRIS) similar across both arms.

Delighted to see our long-acting injectible ART trial (IMPALA) presented at #IAS2025. 2-monthly injections are non-inferior to daily pill taking and overwhelmingly preferred. Next challenge is expanding access to LA ART; excellent news the WHO has recommended LA CAB+RPV in treatment guidelines.

Describing the hawkeye automated line calling at Wimbledon as 'AI' can seriously get in the sea.

🚨 NEW PRE-PRINT (currently going through peer review) We conducted a statistical simulation study to assess the impact of imperfect sensitivity and specificity, in the primary outcome definition of tuberculosis infection, in vaccine trials testing a non-inferiority hypothesis.

NEW PRE-PRINT (currently going through peer review) In this secondary analysis of the RIFASHORT trial we classified TB disease severity at baseline and show that for the majority of people 4-months of rifampicin-based treatment, without the use of a quinolone, was non-inferior to the 6-month SOC.

NEW PRE-PRINT (currently going through peer review) In this secondary analysis of the RIFASHORT trial we classified TB disease severity at baseline and show that for the majority of people 4-months of rifampicin-based treatment, without the use of a quinolone, was non-inferior to the 6-month SOC.

If you are at a loose end next Tuesday, come hear me and @danieljgrint.bsky.social talk about endpoints in TB trials Hybrid event, in London and online Most of the same ideas available in written form here www.thelancet.com/journals/lan... #IDSky #TBSky @sgschumacher.bsky.social

Diary date: 27 May 12.45 BST "Defining efficacy endpoints for late phase tuberculosis treatment non-inferiority trials"@danieljgrint.bsky.social @tomayates.bsky.social www.lshtm.ac.uk/newsevents/e...

Oh good ‘ITT analyses are biased’ is back, here using the euphemism ‘diluted’ 🙃 The rules are that you have to: 1. say what your estimand is before saying an analysis is ‘diluted’/‘biased’ 2. admit that there are other reasonable estimands 3. describe how it could be realised in a future population

Reposting for the Monday morning crowd

It was a pleasure working with @tomayates.bsky.social on this comment in @lancetmicrobe.bsky.social It's time for new TB treatment trials to use a more focused primary outcome definition, moving on from the composite outcome that has prevailed for the last decade www.thelancet.com/journals/lan...

Phase I results often don't translate into proven efficacy in late phase trials, but once yearly PrEP against HIV is a tantalising prospect. Very promising.

Interesting trial showing the effect of pre- and post-test counselling and cash transfers on TB treatment outcomes. LTFU outcomes lower in the intervention arm. Evidence that there is scope to improve outcomes beyond new drug regimens; no need to wait for a goldilocks regimen to solve everything.

After falling for 10 years, rates of #tuberculosis in the UK are on the rise. 📈 Join the latest free webinar from @ucltb.bsky.social to discuss why this is happening, and how we can best respond. 📆 Thurs 6 February 🕒 3pm - 5pm 📍 Online Sign up now 👉 https://buff.ly/4agqAxE

<old man sigh> let's give this thing a try