Abstract / Summary
Background : Timely diagnosis and treatment of tuberculosis (TB) is critical for preventing transmission. The authors aimed to define and quantify potential missed opportunities for earlier TB disease diagnosis using electronic health record (EHR) data to support earlier treatment and to reduce community transmission. Methods : The authors retrospectively analyzed EHR data for individuals with newly diagnosed TB disease from a large health system in Minnesota. Individuals were included if they had at least one positive TB culture or polymerase chain reaction test result or at least 15 occurrences of TB diagnosis codes between 1/1/2022-3/31/2025. Definitions of missed opportunities for diagnosis included health care encounters from the 3-12 months prior to TB disease diagnosis where factors supporting earlier diagnosis may have been missed. Results : Of 82 individuals, mean age at TB disease diagnosis was 51 years, over 80% were non-white, and 61% utilized interpreter services. In the 3-12 months prior to TB disease diagnosis, 20 (24.4%) individuals had at least one potential missed opportunity for diagnosis and 11 (13.4%) had at least two. Being older at diagnosis and having either chronic renal failure or chronic kidney disease were characteristics univariately associated with having a missed opportunity for diagnosis. Conclusions : This project revealed patterns of healthcare access among individuals with TB disease, highlighting several potential points of clinical intervention and demonstrating how missed opportunities can be used to inform provider education, reducing delays in TB disease diagnosis and potentially increasing identification of latent TB infection.