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Isoniazid Prophylaxis for Young Adults

Isoniazid Prophylaxis for Young Adults Abstract To the Editor. — We applaud Colice's1 thoughtful analysis of whether or not young adults should take isoniazid chemoprophylaxis. An empirical study would require large subject groups and a long observation period, unlikely to be funded in today's economy, leaving decision analysis as the only tool for resolving the issue. Shortly after the decision tree analysis of Taylor et al,2 Beck and Pauker3 explicated the use of the Markov process for medical prognosis. We saw in it a perfect model for tuberculosis studies. It captured the essence of our clinical impression that the risk of isoniazid lasted but 1 year, but the benefit remained for one's lifetime.4 Tsevat et al,5 by using essentially the same Markov model, showed, however, that the major difference in these studies was the choice in probabilities of the occurrence of pertinent events.We believe that the benefit-risk ratio is even References 1. Colice GL. Decision analysis, public health policy, and isoniazid chemoprophylaxis for young adult tuberculin skin reactors . Arch Intern Med. 1990;150:2517-2522.Crossref 2. Taylor WC, Aronson MD, Delbanco TL. Should young adults with a positive tuberculin test take isoniazid? Ann Intern Med. 1981;94:808-813.Crossref 3. Beck JR, Pauker SG. The Markov process in medical prognosis . Med Decis Making. 1983;3:419-458.Crossref 4. Rose DN, Schechter CB, Silver AL. The age threshold for isoniazid chemoprophylaxis . JAMA. 1986;256:2709-2713.Crossref 5. Tsevat J, Taylor WC, Wong JB, Pauker SG. Isoniazid for the tuberculin reactor: take it or leave it . Am Rev Respir Dis. 1988;137:215-220.Crossref 6. Kopanoff DE, Snider DE, Caras GJ. Isoniazid-related hepatitis . Am Rev Respir Dis. 1978;117:991-1001. 7. Comstock GW. Prevention of tuberculosis among tuberculin reactors: maximizing benefits, minimizing risks . JAMA. 1986;256:2729-2730.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Isoniazid Prophylaxis for Young Adults

Abstract

Abstract To the Editor. — We applaud Colice's1 thoughtful analysis of whether or not young adults should take isoniazid chemoprophylaxis. An empirical study would require large subject groups and a long observation period, unlikely to be funded in today's economy, leaving decision analysis as the only tool for resolving the issue. Shortly after the decision tree analysis of Taylor et al,2 Beck and Pauker3 explicated the use of the Markov process for medical prognosis. We saw...
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Publisher
American Medical Association
Copyright
Copyright © 1991 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1991.00400090150033
Publisher site
See Article on Publisher Site

Abstract

Abstract To the Editor. — We applaud Colice's1 thoughtful analysis of whether or not young adults should take isoniazid chemoprophylaxis. An empirical study would require large subject groups and a long observation period, unlikely to be funded in today's economy, leaving decision analysis as the only tool for resolving the issue. Shortly after the decision tree analysis of Taylor et al,2 Beck and Pauker3 explicated the use of the Markov process for medical prognosis. We saw in it a perfect model for tuberculosis studies. It captured the essence of our clinical impression that the risk of isoniazid lasted but 1 year, but the benefit remained for one's lifetime.4 Tsevat et al,5 by using essentially the same Markov model, showed, however, that the major difference in these studies was the choice in probabilities of the occurrence of pertinent events.We believe that the benefit-risk ratio is even References 1. Colice GL. Decision analysis, public health policy, and isoniazid chemoprophylaxis for young adult tuberculin skin reactors . Arch Intern Med. 1990;150:2517-2522.Crossref 2. Taylor WC, Aronson MD, Delbanco TL. Should young adults with a positive tuberculin test take isoniazid? Ann Intern Med. 1981;94:808-813.Crossref 3. Beck JR, Pauker SG. The Markov process in medical prognosis . Med Decis Making. 1983;3:419-458.Crossref 4. Rose DN, Schechter CB, Silver AL. The age threshold for isoniazid chemoprophylaxis . JAMA. 1986;256:2709-2713.Crossref 5. Tsevat J, Taylor WC, Wong JB, Pauker SG. Isoniazid for the tuberculin reactor: take it or leave it . Am Rev Respir Dis. 1988;137:215-220.Crossref 6. Kopanoff DE, Snider DE, Caras GJ. Isoniazid-related hepatitis . Am Rev Respir Dis. 1978;117:991-1001. 7. Comstock GW. Prevention of tuberculosis among tuberculin reactors: maximizing benefits, minimizing risks . JAMA. 1986;256:2729-2730.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Sep 1, 1991

References