Improve the Risk Groups in Tabby2

[ctesta01]

Do we want to incorporate some kind of documentation or citations around our choice for values and groups used in the application?

Below is an older version of this issue, more focused on which groups to include.

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This question is intended to facilitate the discussion around what (pre-defined) risk groups should be included in Tabby2 as targetable for increased screening coverage in the "Custom Interventions."

Additionally, we have previously stated that we'd like to include sorting into categories close to the following:

• Elevated LTBI Prevalence
• Elevated TB Exposure
• Elevated LTBI to Active TB Progression

It looks to me like the CDC TTT risk groups are only sorted into the last two categories, so we should discuss how to divide the risk groups into these three categories or if there are any changes we should make to the categories.

The CDC Targeted Tuberculosis Testing website provides the following classification of Persons at Risk of Developing TB Disease:

Persons at risk for exposure to persons with TB disease include:

• Close contacts of a person with infectious TB disease
• Persons who have immigrated from areas of the world with high rates of TB
• Residents and employees of high-risk congregate settings (e.g. correctional facilities, homeless shelters, health care facilities)

Persons more likely to progress from LTBI to TB disease include:

• Recent converters (those with an increase of 10 mm or more in size of TST reaction within a 2-year period)
• HIV–infected persons
• Young children who have a positive TST result
• Those with a history of prior, untreated TB or fibrotic lesions on chest radiograph
• Injection drug users
• Those receiving TNF-α antagonists for treatment of rheumatoid arthritis or Crohn’s disease

Clinical conditions that increase the risk of progression from LTBI to TB disease:

• HIV infection
• Low body weight (> 10% below ideal)
• Silicosis
• Diabetes mellitus
• Chronic renal failure or being on hemodialysis
• Gastrectomy
• Jejunoileal bypass
• Solid organ transplant
• Head and neck cancer

Additional categories that we've previously said we should include are:

• Individuals who smoke
• A suggestion from Yelena is to use "Chronic Kidney Failure" with a description that includes mention of End Stage Renal Disease or hemodialysis.
• We would split HIV positive individuals into High and Low CD4 Count Individuals