Accurate diagnosis of disease remains one of the biggest obstacles to global tuberculosis (TB) control. Many national TB control programmes diagnose TB using sputum microscopy, which is notoriously insensitive, particularly in people who are also HIV-positive. Moreover, diagnosis of drug resistance is required to control drug-resistant TB. An accurate, quick, and accessible test for both TB diagnosis and drug resistance is therefore a global priority. In 2010 a promising molecular diagnostic test, the Xpert MTB/RIF assay, was endorsed by the World Health Organization (WHO), and a new Cochrane Diagnostic Test Accuracy Review evaluates this new approach. The evidence from this review is strongly supportive of existing WHO recommendations and further support for this diagnostic test, but unanswered questions remain.
Danielle Cohen and Elizabeth Corbett
The first of a series of editorials celebrating the Collaboration's 20th anniversary.
The Cochrane Collaboration has seen remarkable growth in the past 20 years, growing to involve over 27,000 people from over 100 countries. The Cochrane Library, which houses the systematic reviews prepared by the Collaboration’s researchers and other databases, has also grown and evolved. From its launch in 1996 on CD-ROM and floppy disk, it has evolved into an online platform providing a wide range of high-quality, independent evidence to clinicians, researchers, consumers, and policy-makers.
Harriet MacLehose and John Hilton